Home Beneficiary Helpline Careers About Us Contact Us
Acentra Health - Beneficiary and Family Centered Quality Improvement Organization (BFCC-QIO)
En Español    
man on a computer

On the Healthcare Front

Issue #10: December 2022

Do you receive the On the Healthcare Front?
If not, sign up to receive important news and updates.
It's free.

when should you call kepro?

  • If you are not ready to be discharged from the hospital.
  • If your Medicare skilled services are ending too soon. Examples of skilled services include things like physical therapy and nursing services.
  • If you have a concern about the quality of care you received.
  • If you have a concern about your medical care that needs to be taken care of right away.

Click on the link below for the phone number for your state. These services are free for people who have Medicare. 

Kepro Telephone Numbers


december 5 - 11 is national flu vaccination week

This is just a reminder that there is still time to get your flu shot.

Look at our flu page to read more about the flu or to find where you can get a flu vaccine near you: www.keproqio.com/flu

988 suicide and crisis lifeline available nationwide

woman using mobile phoneWe can all help prevent suicide. The Lifeline provides 24/7, free, and confidential support for people in distress as well as prevention and crisis resources for you or your loved ones.

When you call, text, or chat 988, you will be connected to trained counselors that are part of the existing Lifeline network. They will listen, understand how your problems are affecting you, provide support, and connect you to resources if necessary.

Suicide and crisis lifeline website:

in this issue:

flu and covid-19

immediate advocacy

healthy living

medicare news

what is the difference between the flu and covid-19?

The only way to tell whether you have the flu or COVID-19 is by testing.

Flu and COVID-19 are both illnesses that easily pass from one person to another. But, they are caused by different viruses. COVID-19 is caused by infection with a coronavirus first identified in 2019. Flu is caused by infection with a flu virus.

You cannot tell the difference between flu and COVID-19 by the symptoms alone because they have some of the same signs and symptoms.

Common symptoms include:

  • Fever or feeling feverish/having chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue (tiredness)
  • Sore throat
  • Runny or stuffy nose
  • Muscle pain or body aches
  • Headache
  • Vomiting

Specific testing is needed to tell what the illness is and to confirm a diagnosis.

Read more about the similarities and differences between the flu and COVID-19: ​

If you need a COVID-⁠19 test, these resources are available: www.covid.gov/tests

immediate advocacy services for people who have medicare

If you have Medicare and have a concern about the health care (or related medical services) you had, you can do something about it. You can call Kepro and ask about Immediate Advocacy services. This process can be used to resolve an issue quickly.

immediate advocacy can help fix communication problems with healthcare providers

lab work
Check to see if your test or service is covered by Medicare.

Whenever possible, you should check to see if Medicare will pay for a medical test or procedure BEFORE you get it. This is a good practice that will help you to avoid having to pay for medical care yourself.

Let’s look at an example.

Artie was good about scheduling and going to his annual wellness visit (which is covered by Medicare). At a recent appointment, the doctor wanted to do a bit of follow-up blood work. Because of the type of blood test he needed to get, Artie had to fast (not eat) for 12 hours. First thing the next morning, he went to the lab.

At check in, the front office staff looked over Artie’s paperwork, including the doctor’s order for the blood work. The staff handed Artie something called an Advance Beneficiary Notice. The notice said that Medicare would not cover his blood work. He was confused because Medicare usually paid for it. In this situation, some of the reasons why Medicare wouldn’t cover this could include (1) the doctor provided a diagnosis that wasn’t accepted by Medicare, (2) staff at the lab couldn’t read the doctor’s writing, or (3) the reason could be something else. Maybe the doctor felt that the test was necessary even though it wasn’t covered by Medicare. 

For a lot of people this is when they would decide to pay to have the test or not pay and not have the test. But, if you’re a person who likes to look for answers involving their medical care, you can call Kepro and ask about Immediate Advocacy services.

When you call Kepro, you will be connected with staff who will help you figure out what’s happening. This is usually done with phone calls with your healthcare provider such as your doctor’s office.

In this example, Kepro Immediate Advocacy staff called the doctor’s office and was able to work through this issue with a couple of phone calls. The patient was able to get his lab work covered by Medicare, thanks to some good detective work from Kepro.

If you are on Medicare and are not happy with the care you received or if you need help working through an issue that needs to be taken care of right away, please call Kepro and ask about Immediate Advocacy services.

Check to see what Medicare covers: www.medicare.gov/what-medicare-covers

Yearly wellness visits: www.medicare.gov/coverage/yearly-wellness-visits

Read more about Immediate Advocacy services: www.keproqio.com/ia

Publication No. R146810-264-12/2022. This material was prepared by Kepro, a Medicare Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 

Disclaimer/Privacy Policy Accessibility Site Map IT Log In
Follow QIO Program on Twitter Watch Kepro BFCC-QIO videos on YouTube Download screen reader for the Visually Impaired Get Adobe Acrobat Reader