About Us
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.
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 Hillsborough County (HCHCP) contract ensures appropriate,
quality-driven care through quality improvement of specified inpatient
hospital, medical and surgical services. KePRO is required to provide prior
authorization, admission and concurrent admission review 24 hours a day, seven
days a week, while providing HCHCP with data collection and trend analysis
reports regarding the utilization of HCHCP services and the quality of
recipient care. In addition, KePRO has implemented an Internet based hospital
quality improvement program.
The Internet based system, developed in conjunction with MEDecision, 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.