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