Medicare Quality Review Services
As the Medicare Quality Improvement Organization (QIO), Oklahoma Foundation for Medical Quality (OFMQ) reviews patient cases under the Medicare Beneficiary Complaint Response Program and conducts other performance monitoring and assessment activities. These review services help ensure patients receive necessary care that meets acceptable quality standards. OFMQ can help providers improve quality where there is opportunity.
We review cases in virtually all health care provider settings for:
- Medical necessity, reasonableness, appropriateness
- Quality concerns
- Validity of diagnostic and procedural information
- Completeness and adequacy of medical and other practices
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 any questions.