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National Elevator
Industry Health Benefit
Plan Participants

Utilization Management, Case Management,
and Care Navigation Services

About Our Program

Acentra Health, formerly Kepro, is honored to have been selected as National Elevator Industry Health Benefit Plan’s Utilization, Case Management and Care Navigation vendor.

Acentra was founded by physicians from the Commonwealth of Pennsylvania Medical Society in 1985, at the request of the Centers for Medicare & Medicaid Services (CMS) to serve as the state’s Quality Improvement Organization (QIO) that monitored the quality-of-care delivery. Today we provide utilization management, case management, and/or quality oversight to more than 300 clients, including Federal, state, and local governments and commercial health plans.

Our Mission is to improve lives through healthcare quality and clinical expertise. We believe in partnering with participants, our clients, and network providers, to ensure participants have access to efficient, high quality, health care that allows for achieving desired health outcomes. With 14 offices and over 3,000 employees across the United States, Acentra Health has improved the lives of more than 77 million participants nationwide.

More information about Acentra Health can be found at: www.acentra.com.

Announcement: 

Enhanced IVR Self-Service: Case Status Access During and After Business Hours

As part of our ongoing commitment to modernize systems and enhance service delivery, we’re excited to share an additional enhancement to our current IVR capabilities.
Current IVR includes:
  • Caller Authentication & Case Status Inquiries – Callers can verify their identity and access real-time case updates without waiting on hold.
  • Expanded Provider Access – Providers can check the real-time status of submitted requests, including approved, denied, pending, or void, regardless of submission method.
  • Streamlined Support – After receiving case details, providers can choose to speak with a representative for additional assistance.
We have now further enhanced the IVR to expand self-service availability beyond regular business hours. Providers can check the status of their requests through the IVR during business hours or after hours, providing greater flexibility and access when they need it.
All case status inquiries will be automatically documented with the date, time, and case details for accuracy and transparency.

 

What Requires Prior Authorization?

Medical
Behavioral Health & Substance Use

Medical

  • Inpatient Hospital
  • Inpatient Rehab
  • Gender Reassignment
  • Transplant
  • Skilled Nursing Services
  • LTAC
  • Home Health
  • Therapies performed in the home (OT, PT, ST)
  • Home IV Therapy
  • Total Parenteral Nutrition
  • Intravenous Immunoglobin (IVIG)
  • Surgical Procedure
  • Pain Management
  • Nutritional Counseling

Behavioral Health & Substance Use

  • Inpatient BH Admission
  • Inpatient SA Admission
  • BH Residential Treatment Facility
  • SA Residential Treatment Facility
  • BH Partial Hospitalization
  • SA Partial Hospitalization
  • Intensive Outpatient
  • Halfway Housing
  • Group Home
North Carolina LIFTSS: Site footer logo

Contact Us
NEIHBP@acentra.com
P: (800) 634-4832
F: (512) 975-7642

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