The Ohio Medicaid Quality Monitor is a quarterly newsletter to help communicate review trends and project information to the doctors, hospitals and health plans that serve Ohio Medicaid clients.

• 2021 |
• 2020 |
• 2019 |
• 2016 |
• 2015 |
• 2014 |
• 2013 |
• 2012 |
• 2011 |
• 2010 |
• 2009 |
• 2008 |
• 2007 |
• 2006 |
• 2005 |
• 2004 |
• 2003 |
• 2002

 

 

2021

• Ohio Medicaid Utilization Review Newsletter, Volume 20 #4

• Ohio Medicaid Utilization Review Newsletter, Volume 20 #3

• Ohio Medicaid Utilization Review Newsletter, Volume 20 #2

• Ohio Medicaid Utilization Review Newsletter, Volume 20 #1

2020

• Ohio Medicaid Utilization Review Newsletter, Volume 19 #5

• Ohio Medicaid Utilization Review Newsletter, Volume 19 #4

• Ohio Medicaid Utilization Review Newsletter, Volume 19 #3

• Ohio Medicaid Utilization Review Newsletter, Volume 19 #2

• Ohio Medicaid Utilization Review Newsletter, Volume 19 #1

2019

• Ohio Medicaid Utilization Review Newsletter, Volume 18 #2

• Ohio Medicaid Utilization Review Newsletter, Volume 18 #1

2016

• Ohio Medicaid Quality Monitor, Volume 17 #1

2015

• Ohio Medicaid Quality Monitor, Volume 16 #1

2014

• Ohio Medicaid Quality Monitor, Volume 15 #2

• Ohio Medicaid Quality Monitor, Volume 15 #1

2013

• Ohio Medicaid Quality Monitor, Summer 2013

• Ohio Medicaid Quality Monitor, Spring 2013

• Ohio Medicaid Quality Monitor, Winter 2013

2012

• Ohio Medicaid Quality Monitor, Summer 2012

• Ohio Medicaid Quality Monitor, Spring 2012

• Ohio Medicaid Quality Monitor, Winter 2012
  New ICD-10: What? Why? When? How?
  Current Quality Improvement Activity
  Where Do You Go For Help with MITS?

2011

• Ohio Medicaid Quality Monitor, Autumn 2011
  Hospital Peer Group Pattern Analysis
  Where is the Quality in Health Care Reform?
  Required Documentation for Outpatient Claims

• Ohio Medicaid Quality Monitor, Summer 2011
  A Look at the Ohio Medicaid Developmental Disability Programs
  New Year! New Contract!
  New ImageNow Process

• Ohio Medicaid Quality Monitor, Spring 2011
  CMS’ HACs and POA: What are they?
  Observation Level of Care
  MITS = Paperless Prior Authorization and Precertification

• Ohio Medicaid Quality Monitor, Winter 2011
  Bill Audit Project
  EHRs and Meaningful Use
  EDI Protocols

2010

• Ohio Medicaid Quality Monitor, Autumn 2010
  Health Care Reform
  Prior Authorization Through MITS
  Forecasting the Future for EDs

• Ohio Medicaid Quality Monitor, Summer 2010
  Unlisted Codes: Part Two
  Appeals and Reconsiderations of Determinations of Hospital Inpatient Services
  Quality of Care Findings SFY 2008

• Ohio Medicaid Quality Monitor, Spring 2010
  Unlisted Codes: Right, Wrong or Time for Change
  Ohio Medicaid Therapy Payment Changes
  Current Quality Improvement Activities

• Ohio Medicaid Quality Monitor, Winter 2010
  Hospital Payments are Linked to Patient Safety
  OAC Rule Changes
  How to Submit a Claim After a Denial

2009

• Ohio Medicaid Quality Monitor, Autumn 2009
  Utilization Trends of Medicaid MRI Use
  Comparing Medicaid Developmental Disabilities Facility and Waiver Programs
  Obtain Precertification at HMSPermedion.com

• Ohio Medicaid Quality Monitor, Summer 2009
  When Every Code Counts
  Welcome New Permedion Project Manager
  Facility E & M Coding

• Ohio Medicaid Quality Monitor, Spring 2009
  The Growing Need for Interpreter Services in Health Care
  Additional Statement Added to Permedion Denial Letters
  Coding Malocclusion of Teeth

• Ohio Medicaid Quality Monitor, Winter 2009
  Quality of Care Findings SFY 2007
  New Quality Improvement Studies
  Helpful Hints: Rebilling a Permedion Denial

2008

• Ohio Medicaid Quality Monitor, Autumn 2008
  Report on Recent Hospital Peer Group Patterns
  Present on Admission Reporting Guidelines
  Denial Hierarchy Table Applied During Retrospective Review

• Ohio Medicaid Quality Monitor, Summer 2008
  Permedion Presents at NAMPI
  Why are Emergency Departments Crowded?
  Hospital Billing for Hospice Patients

• Ohio Medicaid Quality Monitor, Spring 2008
  The Difference Between Permedion and HCE UR Programs
  Denial Reason Based on Hierarchy Table
  Welcome Dr. A.J. Beisler to Permedion

• Ohio Medicaid Quality Monitor, Winter 2008
  Permedion Review Processes, letter from Dr. David Sand
  Nursing Facility and Waiver Functional Assessment Study
  Billing a Claim that is Exempt from Precertification

2007

• Ohio Medicaid Quality Monitor, Autumn 2007
  Who goes to the Emergency Room?
  Guidelines for Selection of Principal and Secondary Diagnoses
  Report Reveals Hospital Peer Group Patterns

• Ohio Medicaid Quality Monitor, Summer 2007
  Closing the Chart: Examining the Use of Health Care Services at the End of Life
  Change to Permedion’s DRG Reassignment Process
  Ohio Medicaid Quality of Care Findings

• Ohio Medicaid Quality Monitor, Spring 2007
  Understanding Post-Acute Care Recovery Care Facilities
  Billing Instructions for Special Cases
  Who To Contact When Your Facility Changes Name or Location

• Ohio Medicaid Quality Monitor, Winter 2007
  Study Examines Post-Acute Care and Nursing Facility Placement
  SURS to Now Perform Second Level Appeals
  Update Your Contact Person Information with Permedion

2006

• Ohio Medicaid Quality Monitor, Autumn 2006
  Study Examines Hospital Admissions and Readmissions
  New Ohio Medicaid Precertification List
  (Article corrected to remove the word “urgent” from the following sentence: Procedures performed on an urgent or emergency basis do not require precertification.)
  Introducing the new OHP Medical Director

• Ohio Medicaid Quality Monitor, Summer 2006
  Ohio Medicaid Congestive Heart Failure Study
  Acute Coronary Syndrome Guidelines
  CPT Codes That Require Precertification

• Ohio Medicaid Quality Monitor, Spring 2006
  Ohio Medicaid Shift to Managed Care
  Precertification at Permedion.com
  Outpatient vs. Inpatient Observation

• Ohio Medicaid Quality Monitor, Winter 2006
  Ohio Medicaid ABD Diabetes Study
  Medicaid Co-Payment in Emergency Department
  Request for Ohio Medicaid Provider E-mails

2005

• Ohio Medicaid Quality Monitor, Autumn 2005
  Pediatric Asthma
  Ohio Medicaid Billing Update
  Introduction of Permedion’s New Medical Director
  Coding for Pediatric Asthma
  Wheezing as a Symptom

• Ohio Medicaid Quality Monitor, Summer 2005
  Major Findings from Recent Adult Asthma Study
  Quality Review Findings Reported for SFY 2004
  No Reimbursement for Copying Medical Records

• Ohio Medicaid Quality Monitor, Spring 2005
  Hospital Peer Groups Patterns
  New ODJFS Section Handling Administrative Appeals
  New Precertification Codes for 2005

• Ohio Medicaid Quality Monitor, Winter 2005
  Observations on Observation Unit
  New Criteria for Medicaid Reviews
  Avoid Technical Denials

2004

• Ohio Medicaid Quality Monitor, Autumn 2004
  Retrospective Review Denial Hierarchy Table
  Outpatient Observation Services
  Fax Your Way To Precertification

• Ohio Medicaid Quality Monitor, Summer 2004
  Medication Use in Nursing Facilities
  Pattern Analysis Monitor Report Arriving Soon
  Precertification 101

• Ohio Medicaid Quality Monitor, Spring 2004
  Unused Medications in Nursing Facilities
  New Studies on Enhanced Care Management
  Criteria Additions for the Precertification Program

• Ohio Medicaid Quality Monitor, Winter 2004
  Hospital Care Assurance Program Study
  Provider Access to Medicaid Resources
  Information on Enhanced Care Management Program
  ODJFS and Permedion Contact Information

2003

• Ohio Medicaid Quality Monitor, Autumn 2003
  Developing Quality Indicators
  Medicaid Interactive Voice Response System
  Hospital-related HIPAA Policy Changes

• Ohio Medicaid Quality Monitor, Summer 2003
  Medicaid Consumer Guide
  Adverse Drug Events
  Keeping Your Hospital’s Contact Information Up-to-Date

• Ohio Medicaid Quality Monitor, Spring 2003
  Mapping in Health Research Analysis
  Precertification Changes
  Transmittal Letters go Electronic

• Ohio Medicaid Quality Monitor, Winter 2003
  Selection of precertification targets
  Preventing technical denials
  Improved data-collection process

2002

• Ohio Medicaid Quality Monitor, Autumn 2002
  Medicaid’s economic challenges
  Quality concern appeals
  Current studies overview

• Ohio Medicaid Quality Monitor, Summer 2002
  OHP Strategic Plan
  Claims review and appeals
  Order to admit

• Ohio Medicaid Quality Monitor, Spring 2002
  Outpatient utilization
  Pattern analysis reports
  Medical record review process

• Ohio Medicaid Quality Monitor, Winter 2002
  Pain management
  Childhood immunization
  Study steps: data collection and analysis