As a contractor for Medicare, Acentra Health serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Acentra Health provides BFCC-QIO services in 29 states, the general information is relevant to everyone who has Medicare (including Medicare Advantage) and everyone who works with people who have Medicare.  

This episode is a conversation with our guests, Rose Hartnett, RN, MS, Operations Director, and Trena Dodson, LPN, Appeals Manager, for Acentra Health. In this podcast, our guests will share information about our hospital discharge and skilled service termination appeals as well as our new observation appeals. 

For more information about Acentra Health BFCC-QIO, please visit www.acentraqio.com. 

KEY TOPICS 

00:24: Overview, introduction of guests, Rose Hartnett and Trena Dodson 

02:40: What are the different types of appeals? 

07:43: Explanation of the appeals process 

10:43: Examples of why appeals are filed 

12:03: What do physician reviewers look for while reviewing an appeal? 

13:54: Final thoughts  

SUBSCRIBE

Subscribe to our newsletters: Case Review Connections, On the Healthcare Front at www.acentraqio.com.

RESOURCES 

BFCC-QIO Information for stakeholders: www.acentraqio.com/partners 

BFCC-QIO Information for people who have Medicare: www.acentraqio.com/bene 

BFCC-QIO Appeal Information - https://acentraqio.com/bene/appeal.aspx

BFCC-QIO's Case Status Tool (check appeal status) -  https://acentraqio.com/casestatus/

Music: Motivational Upbeat Corporate by RinkevichMusic  

https://soundcloud.com/rinkevichmusic 

https://protunes.net/  

Video Link: https://bit.ly/3NNqGTs