{"id":33,"date":"2025-02-08T07:23:22","date_gmt":"2025-02-08T07:23:22","guid":{"rendered":"https:\/\/acentraqio.com\/?page_id=33"},"modified":"2026-03-03T20:58:34","modified_gmt":"2026-03-03T20:58:34","slug":"providers","status":"publish","type":"page","link":"http:\/\/acentraqio.com\/providers\/","title":{"rendered":"Providers"},"content":{"rendered":"<div id=\"pl-33\"  class=\"panel-layout\" ><div id=\"pg-33-0\"  class=\"panel-grid panel-has-style\" ><div class=\"hero-panel siteorigin-panels-stretch panel-row-style panel-row-style-for-33-0\" data-stretch-type=\"full-width-stretch\" ><div id=\"pgc-33-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-33-0-0-0\" class=\"so-panel widget widget_sow-image panel-first-child panel-last-child\" data-index=\"0\" ><div class=\"left-sec panel-widget-style panel-widget-style-for-33-0-0-0\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-image so-widget-sow-image-default-8b5b6f678277-33\"\n\t\t\t\n\t\t>\n<div class=\"sow-image-container\">\n\t\t<img \n\tsrc=\"https:\/\/acentraqio.com\/wp-content\/uploads\/2025\/03\/HospitalStaff2_AdobeStock_547630056.jpeg\" width=\"525\" height=\"260\" srcset=\"https:\/\/acentraqio.com\/wp-content\/uploads\/2025\/03\/HospitalStaff2_AdobeStock_547630056.jpeg 525w, https:\/\/acentraqio.com\/wp-content\/uploads\/2025\/03\/HospitalStaff2_AdobeStock_547630056-300x149.jpeg 300w\" sizes=\"(max-width: 525px) 100vw, 525px\" alt=\"\" \t\tclass=\"so-widget-image\"\/>\n\t<\/div>\n\n<\/div><\/div><\/div><\/div><div id=\"pgc-33-0-1\"  class=\"panel-grid-cell\" ><div id=\"panel-33-0-1-0\" class=\"so-panel widget widget_sow-editor panel-first-child panel-last-child\" data-index=\"1\" ><div class=\"right-sec panel-widget-style panel-widget-style-for-33-0-1-0\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<h1>Information for Healthcare Providers<\/h1>\n<div id=\"pl-218\"  class=\"panel-layout\" ><div id=\"pg-218-0\"  class=\"panel-grid panel-has-style\" ><div class=\"constant-text panel-row-style panel-row-style-for-218-0\" ><div id=\"pgc-218-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-218-0-0-0\" class=\"so-panel widget widget_sow-editor panel-first-child panel-last-child\" data-index=\"0\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p>We are the Beneficiary and Family Centered Care Quality Improvement Organization, working to improve the quality of care for Medicare beneficiaries. Our site offers beneficiary and family-centered care information for providers, patients, and families. Welcome!<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><div id=\"pg-33-1\"  class=\"panel-grid panel-has-style\" ><div class=\"top-gap-small bottom-gap-small panel-row-style panel-row-style-for-33-1\" ><div id=\"pgc-33-1-0\"  class=\"panel-grid-cell\" ><div id=\"panel-33-1-0-0\" class=\"so-panel widget widget_sow-editor panel-first-child panel-last-child\" data-index=\"2\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<a href=\"https:\/\/acentraqio.com\">Home<\/a> \/ <\/nav>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-33-2\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-33-2-0\"  class=\"panel-grid-cell\" ><div id=\"panel-33-2-0-0\" class=\"so-panel widget widget_siteorigin-panels-builder panel-first-child panel-last-child\" data-index=\"3\" ><div id=\"pl-w69a74b7ad64c9\"  class=\"panel-layout\" ><div id=\"pg-w69a74b7ad64c9-0\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-w69a74b7ad64c9-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-w69a74b7ad64c9-0-0-0\" class=\"so-panel widget widget_sow-editor panel-first-child\" data-index=\"0\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<h2>Overview<\/h2>\n<p>Acentra Health is the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for 29 states. As part of the BFCC-QIO contract with the Centers for Medicare &amp; Medicaid Services (CMS), Acentra Health provides free services to people who have Medicare including:<\/p>\n<ul>\n<li><a title=\"appeals\" href=\"\/providers\/appeals\/\" data-udi=\"umb:\/\/document\/d043a424f8c74187b88ecec530174644\">Hospital discharge and skilled service termination appeals<\/a><\/li>\n<li><a title=\"complaints\" href=\"\/providers\/complaints\/\" data-udi=\"umb:\/\/document\/3ddbfcfcfaf54651bf12e812ad7754ef\">Quality of care reviews<\/a><\/li>\n<li><a title=\"advocacy\" href=\"\/bene\/advocacy\/\" data-udi=\"umb:\/\/document\/88638a3cb3a447ad85a5fe6df4252aa9\">Immediate Advocacy services<\/a><\/li>\n<\/ul>\n<p>BFCC-QIOs are part of the QIO Program, which is one of the largest federal programs dedicated to improving health quality for people who have Medicare. The mission of the QIO Program is to improve the effectiveness, efficiency, economy, and quality of services delivered to people who have Medicare. Visit the Centers for Medicare &amp; Medicaid Services (CMS) website to <a href=\"https:\/\/www.cms.gov\/medicare\/quality\/quality-improvement-organizations\" target=\"_blank\" rel=\"noopener\">read more about the QIO Program.<\/a><\/p>\n<h2>How Acentra Health Works With Healthcare Providers<\/h2>\n<p>Acentra Health reviews Medicare hospital discharge, skilled service termination, and hospital observation appeals as well as quality of care reviews. Cases are referred to us for a quality of care review from a variety of sources, including Medicare patients and their families or representatives, CMS, and <a href=\"https:\/\/www.cms.gov\/medicare\/coding-billing\/medicare-administrative-contractors-macs\/whats-mac\" target=\"_blank\" rel=\"noopener\">Medicare Administrative Contractors<\/a> (MACs).<\/p>\n<p>The QIO Liaison at your facility will distribute written information from Acentra Health to the appropriate department or administrative leader. Be sure your facility\u2019s contact information is up to date, so you don\u2019t miss any important communication from Acentra Health.<\/p>\n<p>Acentra Health is also responsible for monitoring physician acknowledgement statements for hospitals. Because hospitals are paid under the prospective payment system based on the physician's diagnoses, all newly credentialed physicians must sign a statement that remains on file at the facility before their first admission to the hospital or first claim submission.<\/p>\n<\/div>\n<\/div><\/div><div id=\"panel-w69a74b7ad64c9-0-0-1\" class=\"so-panel widget widget_sow-editor\" data-index=\"1\" ><div class=\"panel-widget-style panel-widget-style-for-w69a74b7ad64c9-0-0-1\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<h3>Action Items For Healthcare Providers<\/h3>\n<ul>\n<li><strong>Update your facility's contact information.<\/strong> Be sure to keep your information up to date, including your facility's designated QIO liaison, so you don\u2019t miss any important communication from Acentra Health. Visit our <a href=\"http:\/\/acentraqio.com\/providers\/updatecontactinfo\/\">Update Your Contact Information page<\/a> to update any of your information.<\/li>\n<li><strong>Update\u00a0<\/strong><a title=\"phystatement\" href=\"\/providers\/phystatement\/\" data-udi=\"umb:\/\/document\/a51299d1eeed4a1daee8e8528177f7a2\">physician acknowledgement statements<\/a><strong>\u00a0and send to Acentra Health annually.<\/strong><\/li>\n<li><strong>Check appeals status online.<\/strong>\u00a0Use Acentra Health's\u00a0<a title=\"CaseStatus\" href=\"\/casestatus\/\" data-udi=\"umb:\/\/document\/f4adbe0f63884879a1e74f80df76cd93\">Case Status tool<\/a>\u00a0to check the status of an appeal online 24\/7.<\/li>\n<\/ul>\n<\/div>\n<\/div><\/div><\/div><div id=\"panel-w69a74b7ad64c9-0-0-2\" class=\"so-panel widget widget_sow-editor panel-last-child\" data-index=\"2\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<h2>Technical Denial Policy<\/h2>\n<p>Pursuant to 42 C.F.R. \u00a7 476.90, as amended on August 31, 2012, at\u00a0<a title=\"technical denial policy\" href=\"http:\/\/www.gpo.gov\/fdsys\/pkg\/FR-2012-08-31\/pdf\/FR-2012-08-31.pdf\" target=\"_blank\" rel=\"noopener\">77 Federal Register pages 53258, 53664-665, 53682-683<\/a>, the BFCC-QIOs\u2019 authority to issue technical denials applies to providers or practitioners of any kind, regardless of setting, when they do not submit the medical records requested.<\/p>\n<p>The regulations also indicate that those providers and practitioners that refuse to allow a BFCC-QIO \u201cto enter and perform the duties and functions required under its contract with CMS\u201d may also be subject to a technical denial. Therefore, a BFCC-QIO may impose a technical denial where providers and practitioners do not comply with the requirements for case review as opposed to simply failing to submit medical records.<\/p>\n<\/div>\n<\/div><\/div><\/div><div id=\"pgc-w69a74b7ad64c9-0-1\"  class=\"panel-grid-cell\" ><div id=\"panel-w69a74b7ad64c9-0-1-0\" class=\"so-panel widget widget_sow-editor panel-first-child\" data-index=\"3\" ><div class=\"related-links arrow-list-style panel-widget-style panel-widget-style-for-w69a74b7ad64c9-0-1-0\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t><h3 class=\"widget-title\">Related Links<\/h3>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<ul>\n<li><a href=\"https:\/\/acentraqio.com\/providers\/appeals\/\">Appeals<\/a><\/li>\n<li><a href=\"https:\/\/acentraqio.com\/providers\/complaints\/\">Beneficiary Complaints<\/a><\/li>\n<li><a href=\"http:\/\/acentraqio.com\/providers\/hwdrg\/\">Higher-Weighted DRG Reviews<\/a><\/li>\n<li><a href=\"https:\/\/acentraqio.com\/providers\/otherreviews\/\">Other Reviews<\/a><\/li>\n<li><a href=\"http:\/\/acentraqio.com\/providers\/cataract\/\">Assistant at Cataract<\/a><\/li>\n<li><a href=\"https:\/\/acentraqio.com\/providers\/medicalrecords\/\">Medical Record Electronic Submission<\/a><\/li>\n<li><a href=\"https:\/\/acentraqio.com\/providers\/providerresources\/\">Educational Resources<\/a><\/li>\n<li><a href=\"http:\/\/acentraqio.com\/webinars\/\">Webinars<\/a><\/li>\n<li><a href=\"https:\/\/acentraqio.com\/providers\/phystatement\/\">Physician Acknowledgement Monitoring<\/a><\/li>\n<li><a href=\"https:\/\/acentraqio.com\/providers\/liaison\/\">QIO Liaison<\/a><\/li>\n<li><a href=\"https:\/\/acentraqio.com\/providers\/agreement\/\">Memorandum of Agreement<\/a><\/li>\n<li><a href=\"https:\/\/acentraqio.com\/providers\/updatecontactinfo\/\">Update Your Contact Information<\/a><\/li>\n<li><a href=\"https:\/\/acentraqio.com\/providers\/becomeareviewer\/\">Become a Peer Reviewer<\/a><\/li>\n<li><a href=\"https:\/\/acentraqio.com\/casestatus\/\">Case Status Check<\/a><\/li>\n<\/ul>\n<\/div>\n<\/div><\/div><\/div><div id=\"panel-w69a74b7ad64c9-0-1-1\" class=\"so-panel widget widget_sow-editor panel-last-child\" data-index=\"4\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<h3>Subscribe To Our Newsletter<\/h3>\n<p>You can learn more about Acentra Health as well as receive news and information from the Centers for Medicare &amp; Medicaid Services (CMS).<\/p>\n<p>Consider signing up if you are a healthcare provider providing services in one of the\u00a0<a title=\"HomePage\" href=\"https:\/\/acentraqio.com\" data-udi=\"umb:\/\/document\/c73a16ad7e4f48fd8e54ba2e5af514cf\">states served by Acentra Health<\/a>\u00a0and receive Medicare payments.<\/p>\n<p style=\"text-align: center;\"><a class=\"button\" href=\"https:\/\/bfccupload.acentra.com\/\" target=\"_blank\" rel=\"noopener\">Subscribe today!<\/a><\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Information for Healthcare Providers<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":61,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"class_list":{"0":"post-33","1":"page","2":"type-page","3":"status-publish","5":"entry","6":"has-post-thumbnail"},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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