related links

• Overview
• Appeals
• Beneficiary Complaints
• Other Reviews
• Medical Record Electronic Submission
• Educational Resources
• Physician Acknowledgement Monitoring
• QIO Liaison
• Memorandum of Agreement
• Update Your Contact Information
• Case Status Check

overview

Acentra Health is a nationally recognized provider of healthcare management solutions in both state and federal government as well as commercial clients. We provide prior authorization, utilization and specialty review, and case and disease management services.

To accomplish our objectives, Acentra Health must have qualified peer reviewers who meet the following federal regulations:

• Must be a doctor of medicine, osteopathy, dentistry, podiatry, or optometry, or another individual who is authorized under Federal or State law to practice medicine, surgery, osteopathy, dentistry, podiatry, or optometry
• Have a current state license
• Are board-certified
• Must either be engaged in active practice in the State or be military physicians who actively practice in a military or Department of Veterans Affairs (DVA) healthcare facility. Active practice means that the physician usually practices (on a routine basis) a minimum of 20 hours per week. 

For peer reviewers interested in working with Acentra Health on Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) reviews, there are three types of cases:

• Discharge Appeals
• Quality of Care
• EMTALA

interested in becoming a peer reviewer for acentra health?

Thank you for your interest in becoming a credentialed peer reviewer or EAP provider for Acentra Health.
Please email the following two (2) documents:

1. Your CV or resume
2. Acentra Health's Credentialing Application (Credentialing Application - PDF)

Applying to be a credentialed provider does not guarantee work with Acentra Health. The Credentialing Team does not have access to case review reimbursement rates. Please send your completed application to acentracredentialing@acentra.com and BFCC_Peer_Reviewers@acentra.com to enable our staff to track your application through the credentialing process.

If you have any questions about becoming a peer reviewer for the Beneficiary and Family Centered Quality Improvement Organization (BFCC-QIO), please email BFCC_Peer_Reviewers@acentra.com.

what to expect with case review

Acentra Health provides liability coverage for peer reviewer activities, and the reviewer's name will remain confidential except instances where identification is required by law or by specific contract. The work that you complete is not discoverable in a court of law, and will only be used for beneficiary protection and quality improvement activities. We provide compensation for our reviewers based on the type of review or service being requested and/or amount allowed by the individual contract for whom the work is being performed. Compensation of services will be made within 45 days of receipt of the completed report and invoice.

While we cannot guarantee any pre-established volume commitments, your approval as a credentialed reviewer will present you with opportunities to work with our organization in both the private and public sector.