Hillsborough County Web Site
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.