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Skip to footer TRICARE Quality Monitoring Contractor BH Application Requests Terms of Use Information & Appeals MCSDC & DPS Resources About Search icon Contact Us Search this website TRICARE Quality Monitoring Contractor Dedicated to Quality. Intelligent Value Acentra Health (formerly Kepro) is the TRICARE Quality Monitoring Contractor (TQMC) as part of TRICARE’s Quality and Utilization Review Peer Review Organization Program. As the TQMC, Acentra provides independent, impartial health care evaluations for Military Health System beneficiaries. Since 2011, Acentra Health has assisted the DHA TRICARE Management Activity and the TRICARE Regional Offices by providing an independent, impartial evaluation of health care provided to more than 9.4 million Military Health System beneficiaries. In addition, Acentra measures and identifies superior health care services and provides comprehensive and timely reviews to ensure appropriate levels of health care for all beneficiaries. In 2016, Acentra expanded its scope of work by managing the integration of direct and purchased care delivery systems to ensure efficient and effective delivery of health care services. Acentra conducts comprehensive health care facility reviews and audits at 54 Military Treatment Facilities worldwide. TQMC Mission Acentra Health (formerly Kepro) is the Defense Health Agency’s (DHA) TRICARE Quality Monitoring Contractor (TQMC) by the Department of Defense, TRICARE Monitoring Activity. As a part of the TRICARE’s Quality and Utilization Review Peer Review Organization Program, and in accordance with the Code of Federal Regulations (CFR) 32 CFR 199.15, the TMA has established the following contractual objectives for the TQMC: To provide an independent, impartial evaluation of the health care provided to the MHS beneficiaries. To evaluate best value health care” as defined in the TRICARE Operations Manual. To measure, evaluate, and identify superior quality health care services and recommend means to transfer successes. To provide comprehensive and timely reviews that are consistent with all TRICARE requirements, reflecting high quality work for all work assigned, including mental health facility certification, peer review for TMA, reconsideration reviews, and Standard of Care determinations for Military Treatment Facility (MTF) malpractice cases. TQMC Primary Responsibilities Retrospective Chart Review for Quality of Care External Reviews for DHA Appeals, Hearings and Claims Collections Division Medical Necessity (Reconsideration) Appeals Military Treatment Facility Standard of Care Peer Reviews Focused Studies Technology Assessments Contact Us tricare@kepro.com P: (877) 841-6413 F: (877) 841-6414 Important Links Privacy Policy Web Accessibility Disclaimer Site Map dashicons-linkedin dashicons-twitter dashicons-instagram This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply Copyright © 2024 Acentra Health. All Rights...