National Elevator
Industry Health Benefit
Plan Participants
Utilization Management, Case Management,
and Care Navigation Services
Who are we
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.
What Requires Prior Authorization?
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