Overview of Services for Healthcare Providers

Overview

Acentra Health is the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for 29 states. As part of the BFCC-QIO contract with the Centers for Medicare & Medicaid Services (CMS), Acentra Health provides free services to people who have Medicare including:

• Hospital discharge and skilled service termination appeals
• Quality of care reviews
• Immediate Advocacy services

BFCC-QIOs are part of the QIO Program, which is one of the largest federal programs dedicated to improving health quality for people who have Medicare. The mission of the QIO Program is to improve the effectiveness, efficiency, economy, and quality of services delivered to people who have Medicare. Visit the Centers for Medicare & Medicaid Services (CMS) website to read more about the QIO Program.

How Acentra Health Works With Healthcare Providers

Acentra Health reviews Medicare hospital discharge and skilled service termination appeals and quality of care reviews. Cases are referred to us for a quality of care review from a variety of sources including people with Medicare (e.g., Medicare patients) and their families or representatives, CMS, and Medicare Administrative Contractors (MACs).

The QIO Liaison at your facility will distribute written information from Acentra Health to the appropriate department or administrative leader. Be sure your facility’s contact information is up to date, so you don’t miss any important communication from Acentra Health.

Acentra Health is also responsible for monitoring physician acknowledgement statements for hospitals. Because hospitals are paid under the prospective payment system based on the physician's diagnoses, all newly credentialed physicians must sign a statement that remains on file at the facility before their first admission to the hospital or first claim submission.