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KEPRO - Beneficiary and Family Centered Quality Improvement Organization (BFCC-QIO)
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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!

Medical record review is the traditional option to resolve a quality of care complaint under Medicare. This is at no cost to the beneficiary. When the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) receives a written complaint about the quality of services received by a Medicare beneficiary, the BFCC-QIO will request a copy of the medical record. A doctor of matching specialty will review the medical record. The review process could take several months to complete, during which the BFCC-QIO will keep the complainant informed of the progress of the review. When the review is complete, the BFCC-QIO notifies the complainant of the final disposition of the complaint.

When review confirms a quality concern, it is referred to the Quality Innovation Network Quality Improvement Organization (QIN-QIO) for quality improvement activities and to engage healthcare providers in making system changes to prevent a similar problem from occurring in the future.

For Area 2, please fax beneficiary complaint medical records to: 844-878-7921
For Area 3, please fax beneficiary complaint medical records to: 844-878-7921
For Area 4, please fax beneficiary complaint medical records to: 844-834-7130

Area 2 includes the following states: District of Columbia, Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia

Area 3 includes the following states: Alabama, Arkansas, Colorado, Kentucky, Louisiana, Mississippi, Montana, North Dakota, New Mexico, Oklahoma, South Dakota, Tennessee, Texas, Utah, Wyoming

Area 4 includes the following states: Iowa, Illinois, Indiana, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, Wisconsin

 


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