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

september is healthy aging month

Get information on prevention and how to manage ongoing health conditions focused on physical and mental health. From exercise tips to diet and nutrition, this is your one-stop shop for caring for yourself and loved ones.

Health for older adults:
www.ncoa.org/older-adults/health

news from medicare

Medicare Open Enrollment Period.

From October 15 to December 7 each year, you can join, switch, or drop a plan. Your coverage will begin on January 1 (as long as the plan gets your request by December 7).

• www.medicare.gov
• www.medicareresources.org/medicare-open-enrollment

in this issue:

medicare & you, the official u.s. government medicare handbook

This gives you a summary of Medicare benefits, coverage decisions, rights and protections, and answers to the most frequently asked questions about Medicare. You can order this book, for free, in different formats such as a printed (paper) copy, audio, or large print. Get more information on www.medicare.gov. This is one of the many publications available for free from Medicare.

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 caregivers, even if a caregiver is providing care to someone in another state

Being a caregiver for someone can be hard. Now, imagine being a caregiver when you live in a different state from the person you’re providing care to. That’s what was happening with Oliver.

Oliver lives in Colorado, and he watches over the care for his dad. His dad and stepmother live independently in a rural part of Maine. Oliver speaks with them regularly to check in and hear how things are going.

His dad had his annual Medicare wellness visit with his primary care doctor. When Oliver asked how the visit went, his dad said that it went okay and that the doctor was concerned about a couple of things , but he couldn’t remember exactly what. He had a follow-up appointment in six months. His stepmother hadn’t gone with him to the appointment.

Of course, Oliver was concerned. Since his dad lives in rural Maine and doesn’t get to the doctor often, he wanted to be sure that his dad was getting the most out of his visit to the doctor. He thought he could get answers by calling the doctor’s office and having a short talk with the doctor about his father’s visit (with his father’s consent). But getting the doctor on the phone was proving to be impossible.

Oliver went on the Medicare website to see if he could find anything that could help. When he found a list of organizations for his state; he decided to call his state’s State Health Insurance Assistance Program (SHIP). SHIPs give insurance counseling and help to people who are eligible for Medicare (and their families, and caregivers). While they weren’t able to help with his issue, they suggested that he call the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for his state, Kepro.

Oliver called Kepro hoping that they would have better luck calling the doctor’s office. While talking with Kepro staff, he was told about a free Kepro service called Immediate Advocacy that could help with his issue. The process included Kepro calling the doctor’s office.

When Kepro tried calling the doctor’s office, the same thing happened – a busy phone line. Kepro then contacted the doctor’s office by fax to request a call-back. Within a day, the doctor’s office called Kepro in response to the fax, and a time was scheduled for the doctor to call the patient’s son.

Afterwards, the patient’s son, Oliver, called Kepro to say “thank you” – the doctor had no idea that he had questions and was glad to speak with him. The doctor also made a note in the patient’s chart to ensure that he was kept informed about his dad’s medical visits to make his role as a caregiver (from across the country) easier.

• Find the State Health Insurance Assistance Program (SHIP) for your state: www.shiphelp.org
• Read about the Immediate Advocacy process: www.keproqio.com/ia
• Have you had your annual wellness visit? It's covered by Medicare.
  Read more: www.medicare.gov/coverage/yearly-wellness-visits
• Visit www.medicare.gov to get answers – and news and updates – about Medicare.

Publication No. R146810-254-9/2022. 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.