Case Review Connections
A Newsletter for Healthcare Providers and Stakeholders
Post-Acute Care Edition
Issue 46: November 2025
Medical Director's Corner
Written by Jessica Whitley, MD, MBA
Medical Record Submission
Post-acute appeals represent one of the highest-volume appeal types reviewed by Acentra Health. Detailed data on appeal volumes can be found in our Annual Reports.
Because of the high number of post-acute appeals, it is critical that the Centers for Medicare & Medicaid Services (CMS) deadlines are strictly followed. While Acentra Health strives to be accommodating to providers, timeliness and completeness of submissions are essential for fair and efficient processing.
Key Points:
Timely Submission Required:
If medical records are not submitted by the required deadline, the appeal will automatically be decided in favor of the beneficiary.
Complete Documentation:
All necessary information must be included on the Medical Records Request Form. If required details are missing, the physician reviewer will also issue a decision in favor of the beneficiary.
Impact of Late or Incomplete Submissions:
A decision in favor of the beneficiary requires issuance of a new notice, potentially restarting the entire appeal process.
Resources:
Acentra Health offers educational videos on both documentation standards and the medical record submission process via our YouTube channel.
Need Assistance?
If you encounter difficulties submitting medical records, please contact the Acentra Health Helpline for assistance.
Appeals Due Dates:
Post-acute: by close of business (COB) local time on the day of notification
Appeals Update
Regarding records submission: Please take extra care to upload records for one Medicare patient at a time. Each patient record should be accompanied by a unique case ID. We’ve seen an increase in submissions where multiple patients are included under a single case ID, which can cause delays.
Case ID numbers: The format of the appeals Case ID numbers will be changing soon to a 9-digit number. This change will affect both the Case Status tool and the medical record upload file.
Video: Please share our updated Medicare appeals video with patients and others you serve if they have questions about appeals or the appeals process.
Acentra Health Resources - PSAs and Medicare Rights Video
We’ve developed two new resources to help you learn about our services.
- Public service announcements (PSAs): Available in English and Spanish, these 30-second spots highlight our Appeals and Immediate Advocacy services.
- YouTube video: A short overview designed specifically for Medicare beneficiaries. If you would like more information about how to use it, visit our Advocacy Resources page.
We invite you to explore these new resources and share them with others who may benefit.
Rural Health Updates
CMS announced new guidance for states seeking funding from the $50 billion Rural Health Transformation Program, established under the Working Families Tax Cuts Act. This historic investment is the largest in rural health care to date. It aims to modernize infrastructure, expand access, and improve quality and outcomes across rural America.
The United States Health and Human Services Secretary, Robert F. Kennedy, Jr., and CMS Administrator, Dr. Mehmet Oz, emphasized that the program will deliver long-term, sustainable improvements that ensure dignity, affordability, and dependable care for rural communities.
Program Goals:
- Healthier communities: Expand preventive care and address root causes of disease.
- Sustainable access: Help rural providers operate efficiently and remain viable care hubs.
- Workforce development: Recruit and retain skilled health professionals in rural areas.
- Innovative care models: Improve outcomes through coordinated and flexible care approaches.
- Technology innovation: Advance digital health, data security, and efficient care delivery.
Learn more and access the Notice of Funding Opportunity: CMS Rural Health Transformation Program.
Watch CMS' message on the program’s impact: YouTube Video.
Feedback
We value your feedback. Please let us know if there is any content that you would like to see covered in our stakeholder/provider newsletter by emailing QIOCommunications@acentra.com.
Publication No. R146810-215-11/2025. This material was prepared by Acentra Health, a Medicare Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.
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A New Look, With the Same Reliable Access
We’re launching our redesigned website in December!
The updated site reflects Acentra Health’s branding and features improved navigation to make information easier to find.
The web address will stay the same, and any pages you’ve bookmarked—including the Case Status tool, available 24/7—will continue to work as before.
National Caregivers Awareness Month
National Family Caregivers Month, observed each November, honors the millions of family members and friends who care for loved ones with chronic health conditions. Led by the Caregiver Action Network (CAN), this annual observance raises awareness of caregiving challenges, educates communities, and promotes greater support and resources for caregivers nationwide. For more information, visit our website.