QIO Changes Update

As reported last month two new QIO entities have begun work in Indiana.  KEPRO is in charge of beneficiary complaints and appeals, and quality of care reviews, while QSource will be responsible for working with providers and the community on multiple, data-driven quality initiatives to improve patient safety, reduce harm, and improve clinical care at their local and regional levels.

Providers have experience some transition pains with KEPRO in the area of processing beneficiary appeals.  It appeared that KEPRO was not able to handle the volume of appeals, which has created problems for beneficiaries and providers alike with obtaining appropriate Medicare coverage.  To assist with the appeal process, providers are encouraged to use the Expedited Determination Contact Information for Discharge Appeals for appeals that are time sensitive.

On the quality improvement side, Indiana’s long term care community is thrilled that Kathy Hybarger has been hired by QSource to continue her great work in quality improvement.  Kathy’s contact information is below.  QSource issued this introduction letter to providers about their operations and the name of the territory that they cover, dubbed the Atom Alliance (covering IN, TN, KY, AL, and MS).  Congratulate Kathy as you are able and you’ll be hearing more from her and QSource in the very near future.

Kathy Hybarger  RN, MSN
Task Lead for Nursing Homes, Hospital, and Care Coordination
Phone:765-413-9764
e-mail:  Kathy.Hybarger@hcqis.org