Kepro balances accuracy with efficiency during the appeals and grievances process.
With more than 500 clinicians and 3,000 credentialed physicians on our physician panel, we have the expertise needed to do all types of specialty matches. These individuals use established nationally recognized criteria, alongside current medical guidelines, to make highly-accurate decisions. In addition, we manage grievances by acting as a mediator to resolve issues between members and their providers while thoroughly investigating the grievance.
We also provide education on the appeals process. Throughout these efforts, Kepro maintains a flexible process based on your organization’s unique systems, regulatory criteria, time frames and requirements. As a result, your team can focus on other mission-critical functions like managing claims while we take on these resource-intensive processes.
Meet EQR requirements and improve patient care with sophisticated data analysis.
Reach successful conclusions with flexible processes that work for your organization's unique systems and criteria.
Achieve high-quality long-term services and supports with comprehensive Medicaid waiver oversight and accountability.
Promote continuous quality improvement through objective quality reviews.
