Aging Health Matters: Recent Episodes
Kepro QIO Communications
Kepro is a Beneficiary and Family Centered Care Quality Improvement Organization, also called a BFCC-QIO. This podcast will cover topics that affect people who have Medicare. Episodes will include Medicare rights and health care. We hope you tune in for helpful tips that can improve the healthcare journey of you or someone you know. For more information about Kepro, please visit www.keproqio.com.
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 guest, Dr. Jessica Whitley, Chief Medical Officer for Acentra Health. She will share information about appeals and how you can protect your skilled nursing facility benefits.
For more information about Acentra Health BFCC-QIO, please visit https://www.acentraqio.com.
KEY TOPICS
00:24: Overview, introduction of Dr. Jessica Whitley
01:30: Who issues the Notice of Medicare Non-coverage?
06:28: What are skilled services?
10:19: Therapy participation
14:15: Medical record review
16:54: How you can help yourself in the skilled nursing facility
26:04: Final thoughts
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Frontat https://www.acentraqio.com.
RESOURCES
BFCC-QIO Information for stakeholders: https://www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: https://www.acentraqio.com/bene
BFCC-QIO Information for people filing an appeal: https://acentraqio.com/bene/appeal
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
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 guest, Dr. Angeline Brunetto, Associate Medical Director for Acentra Health. She will share information about skin cancer awareness to commemorate Skin Cancer Awareness Month, which is the May health observance.
For more information about Acentra Health BFCC-QIO, please visit www.acentraqio.com.
KEY TOPICS
00:24: Overview, introduction of Dr. Angeline Brunetto
01:16: Why does sun safety matter?
02:57: What causes skin cancer?
03:19: How can you protect your skin?
05:08: ABCDEs of Melanoma
07:40: 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
Centers for Disease Control and Prevention (CDC) – Public health information on skin cancer basics, risk factors, sun safety, and prevention -
https://www.cdc.gov/skin-cancer/
National Cancer Institute (NCI) – Patient-oriented info on skin cancer (including melanoma), prevention, screening, treatment, and research -
https://www.cancer.gov/types/skin
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
RESUMEN
Como contratista de Medicare, Acentra Health se desempeña como la Organización para el Mejoramiento de la Calidad de la Atención Centrada en el Beneficiario y la Familia (BFCC-QIO), también conocida como BFCC-QIO. Aunque Acentra Health ofrece servicios de BFCC-QIO en 29 estados, la información general es relevante para todas las personas que tienen Medicare (incluyendo Medicare Advantage) y para quienes trabajan con personas que tienen Medicare.
Este episodio es presentado por Carla Boguslawski, MBA, MEd, BS, Gerente de Operaciones IA/QOC en Acentra Health.
En este pódcast, nuestra presentadora compartirá información sobre los servicios gratuitos disponibles a través de Acentra Health.
Para obtener más información sobre BFCC-QIO de Acentra Health, visite www.acentraqio.com.
TEMAS CLAVE
00:23: Descripción general e introducción de la presentadora
01:57: Información general sobre la Organización para el Mejoramiento de la Calidad de la Atención Centrada en el Beneficiario y la Familia (BFCC-QIO)
5:47: Proceso de apelaciones de Acentra Health
8:36: Nuevo programa de Asistencia Inmediata para el Alta Hospitalaria (IADA)
13:12: Quejas sobre la calidad de la atención y el proceso de Apoyo Inmediato
20:00: Herramienta de Estado del Caso
21:18: Resumen y reflexiones finales
SUSCRÍBASE
Suscríbase a nuestros boletines: Case Review Connections→ (Conexiones para la Revisión de Casos) y On the Healthcare Front→ (Al Frente del Cuidado de la Salud) – www.acentraqio.com/newsletters
RECURSOS
Información sobre BFCC-QIO para partes interesadas y personas con Medicare: www.acentraqio.com/bene/espanol/
Canal de YouTube - Acentra BFCC-QIO - YouTube
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
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 has our Operations Manager, Carla Boguslawski, MBA, MEd, BS, and Melinda Burk, LPN, Clinical Review Nurse, discussing the options related to filing a beneficiary complaint with Acentra Health.
For more information about Acentra Health BFCC-QIO, please visit www.acentraqio.com.
KEY TOPICS
00:21: Overview
01:42: What is a beneficiary complaint?
02:55: What is a medical record review?
03:41: What cannot be reviewed?
06:06: How to file a complaint
08:11: 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 Information to file a complaint and to get forms and resources: www.acentraqio.com/bene/qualityofcarecomp/
Medicare – www.medicare.gov
Our address is 1650 Summit Lake Dr. Suite 102, Tallahassee, FL 32317 or by e-mail beneficiary.complaints@acentra.com.
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
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 guest from Acentra Health: Dr. Angeline Brunetto, Associate Medical Director for Appeals
In this podcast, our guest will share information about what Medicare beneficiaries can expect from a visit to the emergency room.
For more information about Acentra Health BFCC-QIO, please visit www.acentraqio.com.
KEY TOPICS
00:22: Overview and introduction
01:04: The emergency room experience
03:56: Medicare coverage
08:18: Key things to know about an emergency room visit
10:06: Tips for people with Medicare
12:03: Myths and misunderstandings
13:54: Summary and final thoughts
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front at our website, 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
YouTube channel - https://www.youtube.com/@AcentraBFCCQIO
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
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 (visit www.acentraqio.com to see the states served), 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 guest, Crystal Strong. She is the Program Director for the State Health Insurance Assistance Program (SHIP) and the Senior Medicare Patrol (SMP) program within the South Carolina Department on Aging (SCDOA). She provides oversight and direction to the state grantees to support their work assisting Medicare beneficiaries, their families, and caregivers through outreach, counseling, and education. In this role, she is also responsible for the education and certification of the counselors/volunteers statewide. Crystal actively supports the program networks by providing training and technical assistance whenever possible. Prior to this position, she has functioned in various roles and programs since 2000 when her tenure at SCDOA began. Crystal holds a Bachelor of Science in Nursing from South Carolina State University.
For more information about Acentra Health BFCC-QIO, please visit https://www.acentraqio.com.
KEY TOPICS
00:21: Overview, introduction of guest, Crystal Strong
02:08: What is SHIP?
02:31: What and when is Medicare Open Enrollment?
03:03: How do SHIPs help with Medicare Open Enrollment?
03:42: Tips for Medicare Open Enrollment
04:20: Summary and final thoughts
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front at https://www.acentraqio.com/newsletters
RESOURCES
BFCC-QIO Information for stakeholders: https://www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: https://www.acentraqio.com/bene/helpline
SC Dept on Aging: https://aging.sc.gov/
Acentra Health Open Enrollment information: https://www.acentraqio.co,/medicareopenenrollment
SHIP Information: https://www.shiphelp.org/
Medicare information: https://www.medicare.gov
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
SUMMARY
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 guest, Dr. Angeline Brunetto, Associate Medical Director for Acentra Health. She will share information about healthy aging to commemorate Healthy Aging Month, which is the September health observance.
For more information about Acentra Health BFCC-QIO, please visit www.acentraqio.com.
KEY TOPICS
00:23: Overview, introduction of guest, Dr. Angeline Brunetto
01:46: What is healthy aging?
02:45: How to stay healthy
09:00: How to get involved in your community
10:58: How to be safe in the aging process
15:38: 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
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
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
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 (visit www.acentraqio.com to see the states served), 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 guest, Ray Walker. He is the Divisional Director for the Medicare Assistance Program at the Oklahoma Insurance Department. Mr. Walker has a Bachelor’s Degree in Communication from the University of Oklahoma and over 20 years experience working in and around the healthcare industry, primarily in the field of insurance. He has had the privilege of speaking to groups across the state and around the country on topics ranging from genetics to team building to Medicare. He currently serves on the Advisory Committee to the State Council on Aging and the SHIP Steering Committee (State Health Insurance Assistance Program). He also serves on the Steering Committee for the Aging Our Way Oklahoma Program.
For more information about Acentra Health BFCC-QIO, please visit https://www.acentraqio.com.
KEY TOPICS
00:23: Overview, introduction of guest, Ray Walker
01:48: What is SHIP?
05:35: When to set up Medicare
06:45: How does SHIP help people with Medicare?
07:43: What is the process for assistance?
11:00: Do they help find financial assistance?
14:40: How is SHIP staffed?
16:27: Summary and final thoughts
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front at https://www.acentraqio.com/newsletters
RESOURCES
BFCC-QIO Information for stakeholders: www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: https://www.acentraqio.com/bene/helpline
SHIP Information –https://www.shiphelp.org/
Oklahoma Department of Insurance - https://www.oid.ok.gov/
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
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 (visit www.acentraqio.com to see the states served), 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 guest, Rich Rasmussen, who serves as the President and CEO of the Oklahoma Hospital Association (OHA). The association serves as the advocacy voice for 153 hospitals and health systems. He has spent 35 years advocating on behalf of hospitals and health systems. OHA is the leader in healthcare quality improvement in Oklahoma and a national voice for healthcare delivery in the state.
Prior to assuming the President’s role at OHA, Rich served as President and CEO of the Montana Hospital Association for five years and the Vice President for Membership Relations at the Florida Hospital Association, a position he held for 28 years. Rich’s community engagement has included serving as a volunteer firefighter, District Captain in the Coast Guard Auxiliary, and membership on numerous boards.
For more information about Acentra Health BFCC-QIO, please visit https://www.acentraqio.com.
KEY TOPICS
00:24: Overview, Introduction of Guest, Rich Rasmussen
03:47: Advocacy by Hospital Associations
05:14: Different Types of Hospitals
08:30: Initiatives Under the Oklahoma Hospital Association
13:27: Quality of Care Side of the Oklahoma Hospital Association
16:01: Summary and Final Thoughts
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front at https://www.acentraqio.com/newsletters
RESOURCES
BFCC-QIO Information for stakeholders: www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: https://www.acentraqio.com/bene/helpline
Oklahoma Hospital Association - https://www.okoha.com/
American Hospital Association - https://www.aha.org/
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
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 (visit https://www.acentraqio.com to see the states served), 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 Outreach Specialists, Nancy Jobe and Kia Weaver about their work with providers and stakeholders that work with people with Medicare. For more information about Acentra Health BFCC-QIO, please visit https://www.acentraqio.com.
KEY TOPICS
00:24: Overview, introduction of guests, Nancy Jobe and Kia Weaver
02:55: Role of the Outreach Specialist and how collaboration works
04:20: Description of stakeholder and ones Acentra Health works with frequently
05:56: Services we offer to stakeholders
07:47: Partnerships with other organizations, including those that work with underserved and rural
12:40: Summary and final thoughts
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front at https://www.acentraqio.com/newsletters
RESOURCES
BFCC-QIO Information for providers: www.acentraqio.com/providers
BFCC-QIO Information for stakeholders: www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: https://www.acentraqio.com/bene
Request a Speaker - https://acentraqio.com/partners/frmSpeaker.aspx
Nancy Jobe – Nancy.Jobe@acentra.com or Kia Weaver – Kia.Weaver@acentra.com for presentations on Acentra Health’s BFCC-QIO services
Music: Motivational Upbeat Corporate by RinkevichMusic https://soundcloud.com/rinkevichmusic, https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
SUMMARY
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 (visit www.acentraqio.com to see the states served), 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 guest, Crystal Strong, the Program Director for the State Health Insurance Assistance Program (SHIP), the Medicare Improvements for Patients and Providers Act (MIPPA) program, and the Senior Medicare Patrol (SMP) program within the South Carolina Department on Aging (SCDOA). She provides oversight and direction to the state grantees to support their work assisting Medicare beneficiaries, their families, and caregivers through outreach, counseling, and education. In this role, she is also responsible for the education and certification of the counselors/volunteers statewide. Crystal actively supports the program networks by providing training and technical assistance whenever possible. Prior to this position Crystal has functioned in various roles and programs since 2000 when her tenure at SCDOA began. Crystal holds a Bachelor of Science in Nursing from South Carolina State University.
For more information about Acentra Health BFCC-QIO, please visit https://www.acentraqio.com.
KEY TOPICS
00:24: Overview, introduction of guest, Crystal Strong
01:58: Information about the SMP program
03:31: Tips for people with Medicare
04:14: How does SMP work with stakeholders
04:54: Summary and final thoughts
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front at https://www.acentraqio.com/newsletters
RESOURCES
BFCC-QIO Information for stakeholders: www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: https://www.acentraqio.com/bene/helpline
Senior Medicare Patrol (SMP) - https://smpresource.org/
State Health Insurance Assistance Program (SHIP) and Senior Health Insurance Benefits Assistance Program (SHIBA): https://www.shiphelp.org/
South Carolina Department of Aging - https://aging.sc.gov/
Medicare: https://www.medicare.gov/
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
SUMMARY
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, David Miller, MHA, RN, Operations Director, and Natalie Palmer, BSN, RN, Clinical Review Manager, from Acentra Health. In this podcast, our guests will share information about our free Immediate Advocacy services that can assist with solving medical problems quickly and our IADA services that are available to Medicare beneficiaries that have filed a discharge appeal.
For more information about Acentra Health BFCC-QIO, please visit www.acentraqio.com.
KEY TOPICS
00:21: Overview, introduction of guests, David Miller and Natalie Palmer
02:09: What is Immediate Advocacy and how does it work?
03:37: Examples of Immediate Advocacy
09:53: What is Immediate Advocacy Discharge Assistance?
13:34: Differences between Immediate Advocacy and other Acentra Health review types
15:23: Final thoughts
SUBSCRIBE
Subscribe to our newsletters on our website: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: www.acentraqio.com/bene
Acentra Health’s Immediate Advocacy Information - https://acentraqio.com/bene/advocacy.aspx
Acentra Health’s Immediate Advocacy Discharge Assistance Information - https://acentraqio.com/providers/appeals.aspx
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
SUMMARY
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 guest, Ed Guzmán, the Regional Ombudsman for the Olympic Washington region. He was born and raised in NYC and worked as a teacher. He eventually went to Southern California for graduate school in philosophy.
He has worked in advocacy for approximately three years. He spent one year as an Assistant Regional Ombudsman for the Olympic Region Long-Term Care Ombudsman Program. Since July 2023, he has served as the Regional Ombudsman for the Olympic Region. He is passionate about advocacy and empowering the self-determination of facility residents in Washington state.
In this podcast, Mr. Guzmán will share information about some of the differences between skilled nursing care and long-term care, how Medicare pays for skilled care, skilled service terminations with Acentra Health, and a successful reconsideration in his state.
For more information about Acentra Health BFCC-QIO, please visit www.acentraqio.com.
KEY TOPICS
00:29: Overview, introduction of guest, Ed Guzmán
02:22: Differences between skilled nursing and long-term care
04:54: Requirements for Medicare to pay for skilled care
07:23: Information about appealing a skilled service termination with Acentra Health
09:28: Successful reconsideration
12:19: Final thoughts
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: www.acentraqio.com/bene
Washington State Long-Term Care Ombudsman Program: https://www.waombudsman.org/
Acentra Health’s Skilled Service Appeal Information - https://acentraqio.com/bene/appeal.aspx
Music: Motivational Upbeat Corporate by RinkevichMusic https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
SUMMARY
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 (visit www.acentraqio.com to see the states served), 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 guest, Kathy Madden who works for the Colorado Department of Regulatory Agencies, Division of Insurance. She has been the State Health Insurance Assistance Program (SHIP)/Senior Medicare Patrol (SMP) Partners Services and Training Manager for 12 years. She spent most of her career training all over the country on various topics in the Human Services realm before joining SHIP.
She has experience and knowledge about Medicare, Medigap, Medicare Advantage, and Medicare-related topics. Kathy is passionate about advocating for seniors and understands that consumer education is key to beneficiaries making information Medicare decisions and preventing fraud and abuse within the Medicare program. She is excited and honored to help consumers, stakeholders, and partners navigate the complex Medicare system.
For more information about Acentra Health BFCC-QIO, please visit https://www.acentraqio.com.
KEY TOPICS
00:25: Overview, introduction of guest, Kathy Madden
02:25: Information about the SHIP program
04:30: What is Medicare Open Enrollment?
07:58: What is Medicare Advantage Open Enrollment?
11:46: Medicare Plan Finder tool
14:47: Summary and final thoughts
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front at https://www.acentraqio.com/newsletters
RESOURCES
BFCC-QIO Information for stakeholders: www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: https://www.acentraqio.com/bene/helpline
SHIP and Senior Health Insurance Benefits Assistance Program (SHIBA): https://www.shiphelp.org/
Medicare: https://www.medicare.gov/
Music: Motivational Upbeat Corporate by RinkevichMusichttps://soundcloud.com/rinkevichmusic
https://protunes.net/ Video Link: https://bit.ly/3NNqGTs
Title: Medicare Assistance Programs
SUMMARY
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 guest, Jeff Young, an Outreach and Education Specialist on the Local Engagement and Administration team at the Centers for Medicare & Medicaid Services (CMS) in Region 10, which services Alaska, Idaho, Oregon, and Washington. His role includes working closely with Congressional offices as well as conducting presentations, trainings, and community events on Medicare Programs across the region. Additionally, he works extensively on several key CMS initiatives, including Medicare Open Enrollment, Health Insurance Marketplace, and Medicaid Renewals. He joined CMS as an intern while obtaining his MPA from Seattle University. Upon completion of his MPA in 2020, he rose to the role of Outreach Specialist and has conducted numerous presentations, reached underserved populations, and prides himself in providing excellent customer service and communication.
For more information about Acentra Health BFCC-QIO, please visit https://www.acentraqio.com.
KEY TOPICS
00:24: Overview, introduction of guest, Jeff Young
01:35: Medicare updates from the Inflation Reduction Act
05:30: New income guidelines
06:39: Getting help with your Part B premium
10:45: Summary and final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front at https://www.acentraqio.com/newsletters
RESOURCES
BFCC-QIO Information for stakeholders: www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: https://www.acentraqio.com/bene/helpline
State Health Insurance Assistance Program (SHIP) and Senior Health Insurance Benefits Assistance Program (SHIBA): https://www.shiphelp.org/
Medicare: https://www.medicare.gov/
Music: Motivational Upbeat Corporate by RinkevichMusic https://soundcloud.com/rinkevichmusichttps://protunes.net/ Video Link: https://bit.ly/3NNqGTs
SUMMARY
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 from Acentra Health: Cheryl Cook, Program Director, Rose Hartnett, Operations Director for Appeals, and David Miller, Operations Director for Quality of Care and Immediate Advocacy.
In this podcast, our guests will share information about the free services available from Acentra Health.
For more information about Acentra Health BFCC-QIO, please visit www.acentraqio.com.
KEY TOPICS00:23: Overview, introduction of guests
01:57: General information about the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO)
05:47: Acentra Health’s appeal process
08:36: New Immediate Advocacy Discharge Assistance (IADA) program
13:12: Quality of Care complaints and the Immediate Advocacy process
20:00: Case Status tool
21:18: Summary and final thoughts
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: www.acentraqio.com/bene
YouTube channel
Music: Motivational Upbeat Corporate by RinkevichMusic https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
SUMMARY
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 guest, Juan Garcia, Health Insurance Specialist for the Centers for Medicare & Medicaid Services, Region 10. He has a primary focus on establishing and maintaining positive, collaborative relationships with stakeholders in the Latino and Asian Pacific Islanders Communities in WA, OR, ID, and AK, Language Access Project. He is also the Liaison for the State Health Insurance Programs in Region 10. He serves as CMS Regional Chair for the Employee Resource Group (ERG). Juan has worked for the Centers for Medicare & Medicaid Services since 1997. He received his BA from Eastern Washington University in Sociology and Social Work in 1989, and he received his Master's in Public Administration with an emphasis in Health Care Management in 1996 from Eastern Washington University.
In this podcast, Mr. Garcia will share information about the parts of Medicare, Medicare Advantage plans, Medigap policies, and benefit periods/reserve days.
For more information about Acentra Health BFCC-QIO, please visit www.acentraqio.com.
KEY TOPICS00:24: Overview, introduction of guest, Juan Garcia
01:47: Intro to the parts of Medicare
10:10: Medicare Advantage plans
13:25: Medigap policies
14:52: Benefit periods/reserve days
16:53: Summary and final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front.
RESOURCESBFCC-QIO Information for stakeholders: www.acentraqio.com/partners
BFCC-QIO Information for people who have Medicare: www.acentraqio.com/bene
Office of the Insurance Commissioner: www.insurance.wa.gov/
State Health Insurance Assistance Program (SHIP) and Senior Health Insurance Benefits Assistance Program (SHIBA): www.shiphelp.org/
Medicare: www.medicare.gov
Music: Motivational Upbeat Corporate by RinkevichMusichttps://soundcloud.com/rinkevichmusichttps://protunes.net/ Video Link: https://bit.ly/3NNqGTs
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest, Amy Hagel, SHINE Liaison & Volunteer Manager at Senior Connection Center. Amy is pursuing a Master's Degree in Public Administration and a graduate certificate in Nonprofit Management from the University of South Florida. With over five years of experience at the Senior Connection Center, Amy is a dedicated professional driven by a desire to empower seniors through education and resources. She wears multiple hats as the SHINE (Serving Health Insurance Needs of Elders) Program Liaison and Volunteer Manager. Amy ensures the smooth operation of the agency's SHINE program, manages volunteers, and serves as the agency liaison for the program.
In this podcast, Ms. Hagel will share information about the groups that make up the Hispanic population, health risks in that population, and ways to improve health outcomes.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Overview, introduction of guest, Amy Hagel
02:13: Definition of the Hispanic population
03:41: Health risks in the Hispanic population
05:20: Ways to improve health outcomes
06:29: Information about SHINE in Florida
07:14: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
Florida SHINE (SHIP): www.floridashine.org/
SHIPs in other states: www.shiphelp.org/
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest, Sara Eve Schaeffer, MBA, MA, RD, Director. She works with Health Services Advisory Group (HSAG) in their ESRD National Coordinating Center (NCC).
With 15+ years of experience in kidney care, Sara Eve Schaeffer has worked across the spectrum of end-stage renal disease (ESRD). She has led national ESRD projects for the Center for Medicare & Medicaid Services (CMS) kidney-focused contracts. Sara Eve is also a seasoned strategic operations expert, having served as Vice President of Strategic Operations at a kidney-focused population health company. She serves on the Board of Directors for the American Association of Kidney Patients. She maintains her registered dietitian credentials and holds a Master of Arts degree in Nutrition Education from Immaculata University and a Master of Business Administration degree from Temple University.
In this podcast, Ms. Schaeffer will share information about end-stage renal disease and how it is diagnosed. She will also explain why Medicare focuses on ESRD. She will provide information on the ESRD Network as well as other Medicare contractors that work with ESRD.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Overview, introduction of guest, Sara Eve Schaeffer, MBA, MA, RD
02:03: What is end-stage renal disease (ESRD)?
03:24: Diagnosing ESRD
04:12: Why is Medicare focused on ESRD?
06:25: What is the ESRD Network?
10:05: What is an ESRD NCC?
12:25: What is KCER?
14:36: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
Kidney health resources:
ESRD Networks: https://www.cms.gov/training-education/open-door-forums/end-stage-renal-disease-clinical-laboratories-esrd/network
ESRD NCC: https://esrdncc.org/en/
Music: Motivational Upbeat Corporate by RinkevichMusic https://soundcloud.com/rinkevichmusichttps://protunes.net/ Video Link: https://bit.ly/3NNqGTs
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest, Jessica Whitley, MD, MBA, Chief Medical Officer for Kepro.
In this podcast, Dr. Whitley will share information about things you can do to help prevent heart disease. She shares about lifestyle changes and ways you can monitor the risks that you have.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Overview of second podcast – heart disease prevention
05:39: Lifestyle and genetic factors
12:46: Blood pressure monitoring
16:17: Cholesterol monitoring
17:37: Blood sugar monitoring
20:44: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
Resources for heart disease:
www.cdc.gov/heartdisease/prevention.htm
www.heart.org
Music: Motivational Upbeat Corporate by RinkevichMusic
soundcloud.com/rinkevichmusic
protunes.net/
Video Link: youtube.com/watch?v=ZZH_Dd237EQ
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest, Jessica Whitley, MD, MBA, Chief Medical Officer for Kepro.
In this podcast, Dr. Whitley will share information about different types of heart disease and symptoms of the different types.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Overview, introduction of guest, Jessica Whitley, MD, MBA
04:01: General information about the heart
08:02: Heart attack information
15:08: Atrial fibrillation information
17:38: Congenital heart defect information
19:10: Cardiomyopathy information
21:03: Heart valve disease information
23:20: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
Resources for heart disease:
https://www.cdc.gov/heartdisease/prevention.htm
https://www.heart.org
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest, Swati Guar, Medical Director for Alliant Health Solutions QIN-QIO.
Swati Gaur, MD, MBA, CMD, AGSF, is the Chief Medical Officer for Senior Care Office and Chief Executive Officer for Care Advances Thru Technology, advancing innovations in geriatric care. She is medical director for post-acute care at Northeast Georgia Health System. She is also a medical director for Alliant Health Solutions, a CMS Quality Improvement Organization. She is a member of Georgia Strike and Support Team with Georgia Department of Public Health and University of Georgia. She is medical director with Center of Excellence for Behavioral Health in long term care. She is a clinical assistant professor for Geriatrics at the Augusta University, where she enjoys teaching the principles and art of geriatrics to medical students, internal, and family medicine residents.
In this podcast, Dr. Gaur will share information about fall prevention. She will share information on why fall prevention is important, common causes of falls, and tips for minimizing fall risk.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Overview, introduction of guest, Swati Guar, MD, MBA, CMD, AGSF
02:13: Why fall prevention is important
04:00: Common causes of falls
08:28: Tips for minimizing fall risk
14:55: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest, Talena Ford, Programs Supervisor at the Oklahoma Department of Human Services. Talena Ford has built a career in nonprofit work, helping people access support and resources. She holds a Master's degree in Administrative Leadership from the University of Oklahoma and serves as a Programs Supervisor at the Oklahoma Department of Human Services. In this role, she manages grants that provide support for individuals with special needs and their family caregivers, focusing on home and community-based resources. Talena is committed to finding innovative ways to support family caregivers in Oklahoma. In this podcast, Ms. Ford will share information about caregiving. She will share information on caregiving resources, respite, and ways to improve as a caregiver.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Overview, introduction of guest, Talena Ford
03:13: Information about caregiving resources
05:00: What is respite?
08:47: Ways to improve as a caregiver
13:23: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
Oklahoma caregiving information: https://okcares.org
AAA information: https://eldercare.acl.gov/Public/About/Aging_Network/AAA.aspx
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest, Dr. Jessica Whitley, Chief Medical Officer from Kepro.
In this podcast, Dr. Whitley will share information about health literacy. She will give some tips on how to gather health information as well as sharing about disease prevention. There is also a summary of her advice: obtain, communicate, process, understand, and use with regard to health information.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Overview, introduction of guest, Dr. Jessica Whitley
02:22: What is health literacy?
05:23: How to gather health information
17:07: Summarizing Dr. Whitley’s advice
19:28: Prevention
25:55: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCESBFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
Links Dr. Whitley noted:Health literacy tools from the University of Maryland: www.guides.hshsl.umaryland.edu
Questions to ask your doctor and other tools to help you to be more involved with your care:
www.ahrq.gov/patients-consumers/patient-involvement
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest, Crystal Strong, from the South Carolina Department on Aging.
Crystal is the Program Director for the State Health Insurance Assistance Program (SHIP), the Medicare Improvements for Patients and Providers Act (MIPPA) program, and the Senior Medicare Patrol (SMP) program within the South Carolina Department on Aging (SCDOA). She provides oversight and direction to the state grantees to support their work assisting Medicare beneficiaries, their families, and caregivers through outreach, counseling, and education. In this role, she is also responsible for the education and certification of the counselors/volunteers statewide
In this podcast, Crystal will share information about how the SHIP program can help Medicare beneficiaries with their Open Enrollment choices. Medicare has many options that can be confusing, so this podcast helps provide Medicare beneficiaries with where they can go to get assistance while making these choices.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Overview, introduction of guest, Crystal Strong
02:38: Introduction of SHIPs
03:24: What is Open Enrollment?
04:20: How do SHIPs help with Open Enrollment?
06:15: Tips for Open Enrollment
07:38: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
SHIP information: www.shiphelp.org
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest, Crystal Strong, from the South Carolina Department on Aging.
Crystal is the Program Director for the State Health Insurance Assistance Program (SHIP), the Medicare Improvements for Patients and Providers Act (MIPPA) program, and the Senior Medicare Patrol (SMP) program within the South Carolina Department on Aging (SCDOA). She provides oversight and direction to the state grantees to support their work assisting Medicare beneficiaries, their families, and caregivers through outreach, counseling, and education. In this role, she is also responsible for the education and certification of the counselors/volunteers statewide. Crystal actively supports the program networks by providing training and technical assistance whenever possible. Prior to this position, Crystal has functioned in various roles and programs since 2000 when her tenure at SCDOA began. Crystal holds a Bachelor of Science in Nursing from South Carolina State University.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Overview, introduction of guest, Crystal Strong
02:40: Introduction of Medicare Advantage
03:55: Medigap and Medicare Advantage
04:35: Disadvantages of Medicare Advantage plans
06:15: Types of Medicare Advantage plans
08:35: Open Enrollment
10:10: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
SHIP information: www.shiphelp.org
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest from the Oklahoma Department of Insurance. He will talk about Medigap policies.
Ray Walker is the Divisional Director for the Medicare Assistance Program at the Oklahoma Insurance Department. Mr. Walker has a Bachelor’s Degree in Communication from the University of Oklahoma and over 20 years experience working in and around the healthcare industry, primarily in the field of insurance. Mr. Walker has had the privilege of speaking to groups across the state and around the country on topics ranging from genetics to team building to Medicare. Mr. Walker currently serves on the Advisory Committee to the State Council on Aging and recently completed his second term on the SHIP Steering Committee (State Health Insurance Assistance Program), where he served as the vice chairperson. He also serves on the Leadership Council for the MIPPA Grant Program.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Overview, introduction of guest, Ray Walker
03:09: Introduction of Medigap
05:24: Differences between Medigap and Medicare Advantage
11:01: Differences between Medigap Plans and Medicare Parts
17:11: Medigap and Medicare disability
18:13: Medicare supplement guide
19:57: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
SHIP information: www.shiphelp.org
Supplement policy guide: www.oid.ok.gov
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 from the Quality Innovation Network Quality Improvement Organizations (QIN-QIOs). They will talk about how their organizations work with Kepro, the BFCC-QIO.
Gina Anderson RN, BSN, is a Senior Quality Improvement Facilitator at Telligen. She has worked in and supported nursing homes in a variety of roles for over 25 years including as a Director of Nursing, MDS coordinator, and a nurse consultant. In her current role, she supports healthcare providers across the Telligen region with quality improvement efforts through enhanced assistance, education, and resources. Gina has a strong compassion for building relationships with providers to improve the lives of Medicare beneficiaries.
As a Healthcare Quality Improvement Specialist at TMF Health Quality Institute for over 20 years, Melody Malone is responsible for Nursing Home Quality Improvement for multiple states, but most recently for both Nebraska and Texas. She also works on the CMS Quality Improvement Initiative (QII) with a variety of healthcare providers. In addition, she works on a special project via a HRSA Grant with the University of North Texas Health Science Center in Fort Worth.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:30: Overview, introduction of guests, Gina Anderson and Melody Malone
03:47: Introduction of the QIN-QIO
05:37: Examples of what the QIN-QIO does
10:50: The BFCC referral process
15:20: Examples of a BFCC referral
21:05: Final thoughts
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
QIN information: qioprogram.org
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest from the Area Agency on Aging in Tennessee, Christin McWhorter. She will talk about the services that their organization offers for Medicare beneficiaries. Christin McWhorter is the Community Outreach Manager with the Southeast Tennessee Area Agency on Aging and Disability. Christin has been employed with the Area Agency on Aging for over 16 years and has extensive experience working with older adults and caregivers. As community outreach manager, she collaborates with health organizations, community groups, businesses, and others to promote the agency’s programs and services. She is the manager for the Area Agency’s Community programs, which include Volunteer Assisted Transportation for Seniors, State Health Insurance Assistance Program (SHIP) – Medicare Counseling, health promotion programs, agency volunteer recruitment, and programming/development support for 12 area senior centers.
Christin is a certified leader for several nationally recognized evidenced-based health promotion programs. She facilitates support groups for family caregivers and is a certified Medicare counselor. She is a member of the Mayor’s Council on Livability and Aging, the Chattanooga Regional Health Innovation Coalition, and the Regional Transportation Planning Organization’s Human Services Transportation Committee. For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:12: Overview, introduction of guest, Christin McWhorter
02:47: Introduction of the Area Agency on Aging (AAA)
07:42: Information about costs for services
08:33: How to contact the AAA
10:05: How AAAs work with other stakeholders
11:08: Final thoughts from our guest
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
BFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
Area Agency on Aging Information: eldercare.acl.gov
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest from Kepro. Dr. Jessica Whitley is the Chief Medical Officer for Kepro and works on the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) contract.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:29: Introduction of host and information about Kepro
01:05: Introduction of guest, Dr. Jessica Whitley
04:05: Explanation of person and family engagement
08:30: Ways people can engage in their health care
18:45: How health literacy impacts health outcomes
SUBSCRIBESubscribe to our newsletters, Case Review Connections, On the Healthcare Front: https://keproqio.com/newsletters.aspx
RESOURCES
Information for stakeholders: https://keproqio.com/partners/
Information for people who have Medicare: https://keproqio.com/bene/
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link:
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest from the Senior Medicare Patrol (SMP), Renee Labrie-Shanks. She will talk about how the SMP helps fight Medicare fraud and what Medicare beneficiaries can do to protect themselves.
Renee Labrie-Shanks has been employed at Missoula Aging Services since 2001 and runs the statewide Montana SMP Program since 2006. She has served on the Board of the Montana Gerontology Society, the State Health Insurance Assistance Program Advisory Council, the State Information & Assistance Planning Committee, the Chamber Health Committee, and currently serves on the AARP Executive Council.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
01:13 Overview, introduction of guest, Renee Labrie-Shanks
02:40: Introduction of the SMP program and how they help people with Medicare.
04:12: Examples of when someone would contact the SMP program.
06:40: What happens when fraud is found?
10:09: Information about fraud from telemarketers.
14:40: Additional information about SMP and Kepro.
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front: https://keproqio.com/newsletters.aspx
RESOURCES
Information for stakeholders: www.keproqio.com/partners
Information for people who have Medicare: https://keproqio.com/bene/
Information about the SMP program: https://www.smpresource.org/
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 guest from the Oklahoma Long-Term Care Ombudsman, Bill Whited. He will talk about the services that their organization offers for Medicare beneficiaries.
Bill serves as the State Long-Term Care Ombudsman for the State of Oklahoma and is responsible for administering the Oklahoma’s Long-Term Care Ombudsman network and systems and legislative advocacy for Oklahoma’s long-term care residents. He has more than 25 years of experience in the development and delivery of aging, mental health, juvenile justice, and human services programs in Oklahoma. His background includes over two decades of service with the Oklahoma Department of Human Services, including service as an Adult Protective Services investigator before becoming a Long-Term Care Ombudsman in 2003.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
01:37: Overview, introduction of guest, Bill Whited
03:17: Introduction of Long-Term Care (LTC) Ombudsman Program.
07:00: Examples of when someone would contact the LTC Ombudsman Program.
11:01: How volunteers help staff the LTC Ombudsman Program.
16:30: More information about accessing Kepro’s services and podcasts.
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCESBFCC-QIO Information for stakeholders: www.keproqio.com/partners
BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene
Oklahoma Long-Term Care Ombudsman Program: https://oklahoma.gov/okdhs/services/cap/ombudsman.html
Find the Long-Term Care Ombudsman Program in your state: https://theconsumervoice.org/get_help
Information about the Long-Term Care Ombudsman program: https://acl.gov/programs/Protecting-Rights-and-Preventing-Abuse/Long-term-Care-Ombudsman-Program
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 talks about how the appeals medical record review process works. We have two guests today, who work at Kepro, Dr. Jessica Whitley, who is the Chief Medical Officer, and Rose Hartnett, the Director of Operations in the appeals department.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
01:58: Overview, introduction.
02:30: What is a medical record review and how the process works.
06:35: How you can be more engaged in your health care.
12:30: Things peer reviewers are looking for when they make determinations.
18:40: Getting your questions answered.
19:10: How Immediate Advocacy can help you, if your appeal is denied.
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
- Read about appeals: https://keproqio.com/bene/appeal.aspx
- Watch a video about appeals: www.youtu.be/9q2TKqX0N6k
- Immediate Advocacy services: www.keproqio.com/ImmediateAdvocacy
- Information for stakeholders: www.keproqio.com/partners
- Information for people who have Medicare: www.keproqio.com/bene
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 includes one of our partnering organizations, the State Health Insurance Assistance Program, also known as SHIP for short. We are happy to bring you a conversation between Kia Weaver, a member of Kepro’s Outreach team, and her guest from SHIP, Shirley Thomas.
Shirley is a certified SHIP Medicare Counselor. She was originally a licensed Medical Social Worker, in the state of Ohio. She moved to Georgia in 2009, and in 2010 she started volunteering with The GeorgiaCares Program. She has been with the program for 12 years.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
01:58 Overview, introduction.
02:20: Introduction of guest, Shirley Thomas
03:00: How SHIP helps people who have Medicare
04:00: How to find your local SHIP
04:40: Review of Medicare summary notice and explanation of benefits
05:50: Helpful tips, how SHIPs work with other stakeholders
11:00: Working with the Senior Medicare Patrol (stakeholder)
13:35: Resources
SUBSCRIBE
- Subscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
- Find your local Senior Health Insurance Assistance Program (SHIP): https://www.shiphelp.org/
- Senior Medicare Patrol: https://www.smpresource.org/
KEPRO’S WEBSITE
- Immediate Advocacy services: www.keproqio.com/ImmediateAdvocacy
- Information for stakeholders: www.keproqio.com/partners
- Information for people who have Medicare: www.keproqio.com/bene
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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.
One of the topics that Kepro works with quite a bit and partner to provide information on is caregiving for those with Medicare. This podcast episode coincides with National Caregiver Month, and we are happy to bring you a conversation between Nancy Jobe, one of Kepro’s Outreach Specialists, and two of her partners who will serve as her guests. Nadine Walter from Oklahoma and Gabe Goeres from Montana are speaking about caregiving programs that are in their states and may be available for you as well.
Gabe Goeres was born and raised in Montana. He has spent 12 years working with at-risk youth in the foster care system in Missoula, and five years managing group homes. In his role as care management program manager at Missoula Aging Services, he continues to serve his community.
Nadine Walter began her career in the field of gerontology in 1990 at an Area Agency on Aging in Duncan, OK. She advanced to the state office, OKDHS Community Living, Aging and Protective Services, where she has monitored Area Agencies on Aging; served as the senior housing and legislative liaison; developed and interpreted policies and procedures; and developed the State Plan on Aging. Currently, Nadine oversees several federal and state funded grants that provide supports and resources to individuals with special needs and their family caregivers.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
01:30 Overview, introduction.
05:00: What is caregiving?
06:15: Who are caregivers?
08:40: Challenges of caregiving.
10:15: What does respite mean? Respite programs.
12:10: Memory loss programs.
18:30: Advice for caregivers.
21:45: Resources
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
- Area Agencies on Aging: https://eldercare.acl.gov/Public/Resources/Topic/Caregiver.aspx
- The National Alliance for Caregiving: https://www.caregiving.org/
- Caregiver’s Conference: https://coalitionofcaring.org/
KEPRO’S WEBSITE
- Immediate Advocacy services: www.keproqio.com/ImmediateAdvocacy
- Information for stakeholders: www.keproqio.com/partners
- Information for people who have Medicare: www.keproqio.com/bene
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 about health literacy. We'll talk about what a Beneficiary and Family Centered Care Quality Improvement Organization does for Medicare patients to better understand some of the elements of their care, explaining and communicating clearly some of the medical issues that they've been through and some of the problems that they have faced.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCESImmediate Advocacy: www.keproqio.com/ImmediateAdvocacy
Information for stakeholders: www.keproqio.com/partners
Information for people who have Medicare: https://keproqio.com/bene/
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 focuses on Senior Health Insurance Assistance Program (SHIP) organizations. They offer free Medicare counseling information, unbiased, factual, to everyone on Medicare. This is especially helpful during Medicare open enrollment.
Kepro welcomes guest Janet Peterson Payne who works for Georgia Legal Services as a certified Georgia SHIP Medicare counselor. Georgia SHIP program for Georgia is administered through the Georgia Department of Human Services, Division of Aging. Georgia SHIP provides free, unbiased and factual personalized counseling to assist Medicare beneficiaries. The SHIP program is the only agency endorsed by Medicare to provide these services.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:55: Overview, introduction
04:00: How SHIPs help people who have Medicare
09:05: Medicare open enrollment
22:00: Resources
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
Information about Medicare Open Enrollment
- Find information about your local SHIP: www.shiphelp.org
- YouTube Video
Medicare & You: Medicare Open Enrollment is a video that gives you important information about the Medicare Open Enrollment period - Website
Visit www.Medicare.gov/plan-compare to learn about and compare coverage options and shop for health and drug plans. - Telephone
Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
Information about Kepro’s free services for people who have Medicare
- Immediate Advocacy: www.keproqio.com/ImmediateAdvocacy
- Information for stakeholders: www.keproqio.com/partners
- Information for people who have Medicare: www.keproqio.com/bene
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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 will be centered on rural health. One of the things we'll talk about today with our guest is some of the challenges that are unique to people that live in a rural setting and some of the ways that they encounter some of those issues and ways that Kepro can help them.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:55: Overview, introduction
04:45 Definition of rural; things that people living in a rural health location have to deal with
22:00 Resources
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
- Immediate Advocacy: www.keproqio.com/ImmediateAdvocacy
- Information for stakeholders: www.keproqio.com/partners
- Rural health: www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/rural-health
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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.
In Episode 3, host Scott Fortin, Senior Director, Communications and Outreach at Kepro, is joined by Kim McDonald, Clinical Review Supervisor. If you want to learn more about Immediate Advocacy, a free service for people who have Medicare, you should give a listen to this episode. Scott and Kim talk about what Immediate Advocacy is and give several examples of when to call Kepro and ask for Immediate Advocacy.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:28: Overview, introduction
01:40 What is Immediate Advocacy? How can it help people who have Medicare?
08:40 Examples of when to call Kepro about Immediate Advocacy
15:50 Resources
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCESImmediate Advocacy: www.keproqio.com/ImmediateAdvocacy
Information for stakeholders: Working with Our Partners and Stakeholders
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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.
In Episode 2, host Scott Fortin, Senior Director, Communications and Outreach at Kepro, is joined by Outreach Specialist, Kia Weaver. The conversation gives an insight into how staff work with stakeholders, including the sharing of information that can be passed along to Medicare beneficiaries.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:26: Overview, introduction
02:31: Definition of a stakeholder, how Kepro staff work with stakeholders
06:00: Overview of Immediate Advocacy services
11:30: Resources
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCESInformation for stakeholders: Working with Our Partners and Stakeholders
Watch this podcast on YouTube
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro 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. In Episode 1, host Scott Fortin, Senior Director, Communications and Outreach at Kepro, is joined by BFCC Program Director, Cheryl Cook, RN. The conversation gives listeners details about the free services Kepro offers for people who have Medicare to help them exercise their right to high quality health care. For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
00:25: Overview, introduction
02:30: Appeals
09:00: Quality of care complaints
15:30: Immediate Advocacy services
22:30: Information about Kepro BFCC-QIO, website
SUBSCRIBESubscribe to our newsletters: Case Review Connections, On the Healthcare Front
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link:https://youtu.be/U78mgVaM12M