Helping Providers Give Better Health Care

New

Notification of Review Criteria

OFMQ uses InterQual® as our licensed review criteria. We use the 2009 and 2010 versions for all admissions in 2009 and 2010 respectively, and use updates as they are released each year. Please contact our case review manager if you have questions. 

Hospital Discharge Appeal Notice

Effective July 1, 2007

Current versions of the "Important Message from Medicare" and the "Detailed Notice of Discharge" are posted here on CMS' website along with the Manual Instructions for this process.  

View Web-ex for Providers  Click on "View Event Recordings", then scroll down and select "TX-HINN Provider Training".


Access CMS' Hospital Quality Initiatives web page

Medicare Quality Review

OFMQ provides expert review services to help assure quality of care for Oklahomans. A URAC Accredited organization, we employ health information management professionals, nurses and board-certified physicians to perform medical review, and we have a 2,100-member network of physicians, many of whom may serve as consultants for case review. The review process can identify opportunities to help providers improve quality of care. And working with OFMQ, providers and beneficiaries can be assured of a thorough and thoughtful review that is conducted with professionalism and integrity.