KEPRO to Implement Minnesota's Retrospective Review Program for State Medicaid

HARRISBURG, Pa., July 10, 2017 /PRNewswire/ -- KEPRO announced today that it was awarded a new contract with the state of Minnesota Department of Human Services to perform all retrospective, post-payment reviews for the state's fee-for-service Medicaid program.

KEPRO will be developing and implementing the state's first program to conduct retrospective and post-payment reviews to identify outpatient and inpatient initiatives to enhance the delivery of services and improve overall health outcomes for members of the state's Medicaid program.

"We're grateful for this opportunity to continue our work in the state of Minnesota," said KEPRO President and CEO Joseph A. Dougher. "This program allows us to identify areas where we can deliver outcome-focused solutions to maximize services and improve the quality of life for Minnesotans."

KEPRO currently manages Minnesota's Fee-for-Service Medicaid program and helps 315,000 members receive the quality care they need through utilization management. KEPRO also supports the management of the Emergency Medical Assistance (EMA) program that covers the care and treatment of non-citizens who would otherwise qualify for Medicaid for emergency medical conditions provided in the Emergency Department or inpatient hospital. In addition, KEPRO performs reviews for level of service requests for non-emergency transportation for Fee-for-Service recipients to and from appropriate health care providers and facilities.  

KEPRO's reviews will identify outliers that indicate policy gaps, training needs, and trends in order to encourage best practices in medical care, record keeping, and billing. KEPRO will also be reviewing provider claims to ensure that documentation adheres to the Minnesota Health Care Program's Provider manual, nationally recognized clinical criteria and best practices for medical claims coding.

"We'll be assisting Minnesota in ensuring efficiency and program integrity in the delivery of Medicaid services for their citizens," stated Dougher.

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

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Media Contact: Jamie Kopko, Director of Corporate Communications, [email protected], 717.564.8288 x7076

SOURCE KEPRO

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