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Member Effective Dates
Member Effective Dates: Please note, there are times when you will see an HCHCP member’s effective date in the future when accessing via the Atrezzo portal. If you are able to pull up a member and notice the effective date is in the future, this also validates the member is currently active with the plan until that date. You may still process your case and once the member information and dates of service are entered, the portal will provide you with an alert should the member not have current coverage. If you would like to check member eligibility prior to portal submission, eligibility can be accessed 24/7 by calling IVRS at 813-272-5555. All other eligibility questions can be referred to HCHCP Customer Service at 813-272-5040.
Posted: 1/21/2019
Use of ICD 9 Codes
Effective October 22, 2018, HCHCP is initiating a 4 month long “soft launch” rule change that will no longer allow ICD 9 codes to be used for prior authorization requests. During the soft launch timeframe, please change any ICD 9 codes to ICD 10 when submitting your requests to KEPRO. Beginning February 18, 2019, the system will no longer allow ICD 9 codes and will stop your review from being submitted until an ICD 10 code is utilized. HCHCP network providers are strongly encouraged to only use ICD 10 codes for all request submissions. A notification will be posted on February 18, 2019 when the supporting rule to block ICD 9 codes is implemented.
Posted: 10/23/2018
Announcements
There are no announcements at this time.
Keystone Peer Review Organization, Inc. (KEPRO), an industry leader in providing
innovative, value-added healthcare management solutions, has been awarded the "Medical
Management and Services" contract through Hillsborough County's Health and Social
Services. The Hillsborough County (HCHCP) contract ensures appropriate, quality-driven
care through quality improvement of specified inpatient hospital, medical and surgical
services.
Recognized as the largest federally designated Quality Improvement Organization
(QIO) in the nation, KEPRO's reputation is a result of providing many years of innovative
healthcare management solutions to multiple state Medicaid and Medicare programs,
the Department of Defense's (DoD) national TRICARE program, and 5 of the nation's
largest insurance providers.
The Internet based system uses InterQual criteria to safeguard against unnecessary
or inappropriate use of Medicaid services and provides clients with an enhanced
secure system to perform accurate, confidential medical record review through a
remote-user, virtual private network.
KEPRO is URAC accredited in Health Utilization Management and Case Management. We
are also licensed to perform medical reviews in 29 states.