OMIG (NEW YORK)

Harmony Healthcare International (HHI) provides detailed medical record review to assess if the assigned New York State Medicaid RUG level accurately reflects the care provided.

Harmony HealthCARE Specialists are trained extensively in MDS coding. The State of New York utilizes the OMIG (Office of the Medicaid Inspector General) to determine reimbursement for its Medicaid beneficiaries in the Post-Acute setting. MDS contains extensive information on the resident’s nursing needs, ADL impairments, cognitive status, behavioral problems, and medical diagnoses. Harmony Healthcare International (HHI) is available to assist the provider in understanding state specific regulations for compliant scheduling and completion of the MDS to ensure the accurate reflection of the clinical conditions and services rendered to the long term care population of the SNF.

How can Harmony Healthcare International (HHI) help?

Harmony Healthcare International (HHI) can assist with the following:

Harmony Healthcare International (HHI) provides a comprehensive analysis of the facility's OMIG process and recent audit results. Our Harmony HealthCARE Specialists provide patient specific case management strategies and associated Case Mix impacts to the facility. We assist our customers in developing systems to ensure documentation reflects the care provided. We help our customers continuously strive (via auditing and monitoring) for accurate and appropriate reimbursement while meeting regulatory requirements and reducing documentation redundancy.

Services include:

  • Review of current Medicaid Case Mix Policies and Procedures
  • Medicaid OMIG chart audits (OMIG supporting documentation)
  • OMIG Eligibility and Coverage Criteria
  • OMIG Nursing Documentation Review
  • Compliance Audits for MDS Accuracy, MDS supporting documentation, therapy documentation, nursing documentation, physician certification completion, medical necessity and other needed elements to support claim integrity
  • OMIG ADL Coding:  Supporting Documentation and MDS Accuracy
  • Patient specific case management strategies and associated CMI impact
  • Medicare Part B Therapy Utilization Review (PT, OT and ST)
  • Medicare Part B Therapy Documentation Review 
  • Ongoing facility staff education 
  • Review and Analysis of most recent OMIG Audit Results
  • Monthly OMIG Medicaid Revenue Analysis
  • Comprehensive Written Report  
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