News

KEPRO to Manage TennCare’s Children’s Health Insurance Program and Processing Center

HARRISBURG, PA – KEPRO announced today that TennCare, the state of Tennessee’s Medicaid program, has awarded the Children’s Health Insurance Program, CoverKids, and TennCare’s Application Processing Center contract to KEPRO.

With the new contract, KEPRO will assist the state in the handling of applications, referrals and overall management of the administration and processing required for both programs via an Application Processing Center.

“KEPRO’s growth to provide eligibility services and application processing is an exciting next step for our relationship with TennCare and Tennesseans,” said KEPRO CEO Joseph A. Dougher. “We look forward to providing cost-effective and efficient management, including exemplary customer service to TennCare and CoverKids members.”

The processing center will augment the TennCare and CoverKids call center by handling applications and redetermination information via phone, mail, fax and referral, entering information and completing all state approved eligibility determination application processing tasks. 

For more than a decade, KEPRO has supported the TennCare program through medical necessity, clinical contraindication and hardship reviews, providing medical testimony at fair hearings, in addition to various quality improvement initiatives through audits and analytical analysis. KEPRO also provides training on medical and eligibility appeals processing, as well as onsite IT support. 

In September 2017, KEPRO also began managing TennCare’s toll-free call center assisting members with filing medical issues or appeals by phone.

To learn more about the services and solutions KEPRO offers, visit www.kepro.com.

You can also get health tips, information about our organization or learn about exciting job opportunities by following us on Twitter, on  Facebook or on LinkedIn.

Media Contact: Jamie Kopko, Director of Corporate Communications, JKopko@Kepro.com, 717.564.8288 x7076

About TennCare

TennCare is the state of Tennessee’s Medicaid program which provides health insurance to approximately 1.4 million low-income Tennesseans including pregnant women, children, caretaker relatives of dependent children and older adults and adults with physical disabilities.  With a satisfaction rating above 90 percent since 2009 TennCare provides health insurance through the use of managed care.   

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Mavis O’Neill Appointed Vice President of Growth and Business Development

HARRISBURG, PA – KEPRO, the nation’s largest CMS-designated quality improvement and care management organization, is pleased to announce that Mavis O’Neill will be appointed Vice President, for Growth and Business Development.

Ms. O’Neill will join KEPRO’s leadership team as a strategy, growth and business development lead supporting Public Programs and solution development of KEPRO’s professional service offerings. She will be responsible for pursuing new business prospects while accurately forecasting new business opportunities, strategically build a detailed sales plan with tactics for growth and effectively communicate with all external stakeholders.

 “Ms. O’Neill has a proven track record to perceive client needs and devise clear approaches to both thematic and specific challenges,” said KEPRO’s President and CEO Joseph A. Dougher. “Mavis’ expertise and reputation in the health care industry will be an invaluable asset to our clients and we are excited to see how she develops and grows KEPRO’s professional service solution areas.”

With over 20 years of experience of business development within the technology and federal health space, Ms. O’Neill’s expertise in team-building and analysis will be a key factor in creating innovative solutions for business at KEPRO.

Ms. O’Neill’s role will enhance KEPRO’s client network with highly creative approaches, operational procedure efficiencies, and tactical and strategic perspectives.  

Prior to joining KEPRO, Mavis held various roles at IBM, as well as management in health care firms and technology agencies. She is professionally trained in Artificial Intelligence, Design Thinking, studies and analysis for the federal health care sector. She has a passion for foundational change across the national health care delivery system. Mavis’s ability to creatively problem solve for both large and small businesses helped her achieve multiple wins of more than $100M in large, incumbent captures for federal health.

To learn more about the services and solutions KEPRO offers, visit www.kepro.com.

You can also get health tips, information about our organization or learn about exciting job opportunities by following us on Twitter, on  Facebook or on LinkedIn.

Media Contact: Paige Nauman, Communications Coordinator, PNauman@kepro.com, 717.564.8288 x7041

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Srinivas Achukola Appointed Chief Technology Officer

HARRISBURG, PA – KEPRO is pleased to announce the appointment of Srinivas Achukola as Chief Technology Officer.

Mr. Achukola’s role as KEPRO’s CTO will be to provide leadership along with responsibilities for all aspects of the IT organization including technology, vision, strategy, business applications, data management, information security and service delivery across the company. Also, as a leader of a Healthcare Analytics organization, he will be responsible for delivering health care analytics for operational excellence for KEPRO and their clients.

“Srinivas’ expertise in health care data science and analytics will be an exceptional asset for continued development of KEPRO’s innovative and secure informational technology environments,” said KEPRO President and CEO Joseph A. Dougher. “Our goal is to provide secure and HIPAA compliant IT infrastructure and services, administrative systems and support services, and actionable health data to assist our clients in the efficient and effective management of member services and quality health care.”

Achukola’s role will be instrumental in the design and development of member-centric and customer-focused solutions tailored to the specific business needs of KEPRO’s clients. Achukola’s experience in the engineering of innovative products and solutions as key market differentiators will further KEPRO’s goals for growth and efficiency.

With nearly 30 years of experience in developing technical solutions and strategies, leading integrations in mergers & acquisitions, and positioning IT departments as key business partners for fast market growth, Achukola will lead KEPRO in current solution development and post-acquisition integration to leverage current and future service delivery systems for synergies and efficiencies.

Prior to joining KEPRO, Achukola worked for NaviHealth based in Nashville, Tennessee, where he was the Chief Information Officer. His successful integration strategy and streamlining of clinical and operational workflow processes led to an effective acquisition. Achukola also held various leadership positions in high growth companies like CareCentrix, FuelQuest, KLC and several other global companies. With his strong business acumen, global team-building skills and strategic planning and execution, Achukola has positioned global technology organizations as strategic business partners for growth and efficiency. His lead on innovation and digital transformation has saved five companies between $30M and $60M, adding between $23M and $180M in new business.

Srinivas earned his Bachelor of Engineering, Electrical & Electronics from the National Institute of Technology, India and his Masters of Business Administration from Ravishankar University, India.

To learn more about the services and solutions KEPRO offers, visit www.kepro.com.

You can also get health tips, information about our organization or learn about exciting job opportunities by following us on Twitter, on  Facebook or on LinkedIn.

Media Contact: Paige Nauman, Communications Coordinator, PNauman@kepro.com, 717.564.8288 x7041

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Find an Answer

Please describe KEPRO data security that ensures member information is protected.

As an organization that is charged with storing and transferring Protected Health Information (PHI), KEPRO is bound by HIPAA regulations, and is accustomed to managing the security and privacy of PHI. KEPRO currently exchanges data successfully and confidentially via secure encrypted means in support of all of our federal, state, and local government programs, and with commercial clients.

KEPRO has been implementing and supporting systems that require medical record, data security, and transmission for more than a quarter of a century, and has always placed primary importance on using systems that allow for fast and efficient connectivity, while still providing the highest level of data and system security. Our proven internal and external policies and protocols ensure compliance with state and federal laws and regulations, as well as any additional security measures you may require.

We have a stringent KEPRO Comprehensive Confidentiality Plan that governs our processes. KEPRO’s Privacy Officer, Security Officer, and the Compliance Officer have ultimate responsibility for oversight of the processes and procedures contained in the KEPRO Comprehensive Confidentiality Plan.

KEPRO's system is secure. Our information systems are secured by an in-depth strategy that utilizes multiple layers of operational, management, and technical controls to protect KEPRO assets. We also employ software programs designed to prevent unauthorized use by staff or outside entities.

All KEPRO information systems employ common security controls such as Firewalls, Anti-virus, Role Based Access, FIPS 140-2 Encryption for mobile devices, and the requirement of strong passwords. Information system users are assigned a security role based upon access requirements relevant to their positions and information/program privileges.

The HIPAA Security Rule requires entities to implement information systems that control access to healthcare and related systems. KEPRO adopts a subset of NIST 800-53 Rev 3 Security controls to maintain compliance with HIPAA. Based on these security standards, KEPRO mitigates risk to its Information system by focusing on such controls as:

  • Log-In Security. HIPAA security requires the use of secure User IDs and the use of passwords. KEPRO requires multiple account authentication processes within its information systems to verify the identities of our end-users. KEPRO's policy requires strong passwords that are changed frequently.
  • Access Control. HIPAA requires one of the following: Context Based Access, Role Based Access, or User Based Access. User Based Access is part of the Log-In Security component. KEPRO's Role Based Access gives individual users access relevant to their function in the organization.
  • Audit Trail. HIPAA requires the use of an audit trail to identify who accesses PHI. KEPRO systems track those who change the patient record, the date and time the record was modified, and the specific information changed. The system includes a read only audit trail that captures each time a system user views a case.
  • Session Time-out. KEPRO information systems account for session inactivity by locking screens after 10 minutes of inactivity.
  • KEPRO's physical space is secure. KEPRO’s computer, telephone, and hardware systems are located in climate controlled rooms with fire-suppression and electronic locking system. We allow only authorized access to the room.
  • KEPRO focuses training on confidentiality and security issues. All KEPRO employees undergo rigorous training on security and confidentiality of PHI. We have successfully provided this training to all staff regardless of their respective roles/duties.

KEPRO Headquarters

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777 East Park Drive, Harrisburg, PA 17111
Toll-free: 800.222.0771
Phone: 717.564.8288
Fax: 717.564.3862