Beneficiary Complaints
We are the Beneficiary and Family Centered Care Quality Improvement Organization, working to improve the quality of care for Medicare beneficiaries. Our site offers beneficiary and family-centered care information for providers, patients, and families. Welcome!
Quality of Care Reviews
Medical record review is the traditional option to resolve a quality of care complaint (beneficiary complaint) under Medicare. This is at no cost to the beneficiary (e.g., Medicare patient).
When Acentra Health, a Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO), receives a written complaint about the quality of services received by a Medicare beneficiary, Acentra Health will request a copy of the medical record. A doctor of matching specialty will review the medical record.
The review process could take four to six weeks to complete, during which the BFCC-QIO will keep the person who made the complaint informed of the progress of the review. When the review is complete, the BFCC-QIO notifies that person of the final result of the complaint.
This Process Flow Chart (PDF) shows the appeals process on page 1 and the beneficiary complaint process on page 2.
Medical Record Electronic Submission
Effective October 1, 2020, the Centers for Medicare & Medicaid Services (CMS) requires providers to send medical records to Acentra Health electronically.
Read more about the medical record electronic submission process.
