BiPAP and CPAP Improvements
have been made to the BiPAP and CPAP questionnaires. If your completed
questionnaire meets all medical necessity requirements, it will be auto
approved. If it does not, our clinical team will review it for medical
necessity and will provide you with a determination notification. You may
reference the updated questionnaires in our provider reference section.
Psychiatrist Referral Change Notice
Effective immediately, a referral to a psychiatrist may have a
maximum of 6 visits per request instead of the original 3 visits.
There are no announcements at this time.
Keystone Peer Review Organization, Inc. (KEPRO), an industry leader in providing
innovative, value-added healthcare management solutions, has been awarded the "Medical
Management and Services" contract through Hillsborough County's Health and Social
Services. The Hillsborough County (HCHCP) contract ensures appropriate, quality-driven
care through quality improvement of specified inpatient hospital, medical and surgical
Recognized as the largest federally designated Quality Improvement Organization
(QIO) in the nation, KEPRO's reputation is a result of providing many years of innovative
healthcare management solutions to multiple state Medicaid and Medicare programs,
the Department of Defense's (DoD) national TRICARE program, and 5 of the nation's
largest insurance providers.
The Internet based system uses InterQual criteria to safeguard against unnecessary
or inappropriate use of Medicaid services and provides clients with an enhanced
secure system to perform accurate, confidential medical record review through a
remote-user, virtual private network.
KEPRO is URAC accredited in Health Utilization Management, Disease Management and Case Management. We
are also licensed to perform medical reviews in 29 states.