We are the Medicare 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!
- Overview of Services
- How to File a Quality of Care Complaint
- How to File an Appeal
- Appoint a Representative
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Do you need help with Immediate Advocacy?
Click below to find the phone number for your state.
|Immediate Advocacy can be useful during times of crisis such as during the current situation with the Coronavirus.
Medicare patients have been calling Kepro with various issues such as prescription refill concerns, discharge questions, and concerns about communication with facilities (e.g., hospitals, skilled nursing facilities).
Read a story about how this process can help during a crisis.
|Read the story|
what is immediate advocacy and how does it help people with medicare?
Immediate Advocacy is a free service for people with Medicare. It is used to help people quickly resolve a problem about medical care or services. Immediate Advocacy often involves Kepro calling a healthcare provider or facility on behalf of the patient.
when to use immediate advocacy
You can call Kepro if you have a complaint about the medical care or services you received. Examples of when you can call Kepro:
- The hospital staff will not answer your questions.
- Your doctor ordered a wheelchair, but you have not gotten it yet.
- You need to refill a prescription but can’t get an appointment to see your doctor.
immediate advocacy process
Once Kepro decides that Immediate Advocacy is right for your situation, you will be asked for permission to share your name and concern with your provider. When Kepro calls the provider, we tell them that we have a complaint and that you would like to resolve the complaint through Immediate Advocacy. If the provider agrees, Kepro will begin the process. If the provider does not agree, you can then file a written complaint.
Kepro may use a phone call on your behalf to resolve the complaint. The goal should be a quick and agreeable resolution within eight hours but not more than two business days.
If the provider is not available after you agree to the use of Immediate Advocacy, Kepro will call you to discuss your options. If you are not happy with the outcome of Immediate Advocacy, you can file a written complaint.
stopping immediate advocacy
If you ask to stop the Immediate Advocacy process, you have the right to file a written complaint. If at any point, Kepro finds out information that makes the complaint no longer right for Immediate Advocacy, Kepro must stop the process and tell you and the provider that Immediate Advocacy is done.
immediate advocacy example
A Medicare patient’s husband called Kepro with concerns about his wife’s discharge from a skilled nursing facility. He had a care conference with the surgeon, and it was decided that he could take care of his wife with home health services. However, once his wife was home he had questions. He called Kepro to request help with understanding the plan of care and any options for treatment.
The Clinical Care Coordinator at Kepro left a message for the social worker at the skilled nursing facility. The social worker scheduled a three-way conference call with the home health agency, herself, and the patient’s husband. The meeting gave the patient’s husband a chance to ask follow-up questions to help him and his wife understand the plan of care. Now, they were comfortable with the next steps for continued treatment. The Clinical Care Coordinator had a phone call after with the patient’s husband to be sure that he was now comfortable with the situation.