Welcome to Kepro’s Program site for National Elevator Industry Health Benefit Plan Participants

Utilization Management, Case Management, and Care Navigation Services

What Requires Prior Authorization?

Medical

Inpatient Hospital
Inpatient Rehab
Gender Reassignment
Transplant
Skilled Nursing Services
LTAC
Home Health
Therapies (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
Halfway Housing
Group Home

About Us

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

Who are we?

Kepro 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 1,100 employees across the United States, Kepro has improved the lives of more than 77 million participants nationwide.
 
More information about Kepro can be found at: www.kepro.com.