As a nurse, you are carrying out very important instructions. The instructions were given to you by a physician and treating them seriously helps to make sure that your patients get the care they need. It also helps to protect you (and All Metro) from liability. Every time you visit a patient, take what you are supposed to do there seriously and document the full extent of your activities.
The New York State Office of Medicaid Inspector General ("OMIG") is charged by statute to improve and preserve the integrity of the Medicaid program by conducting various reviews of provider billing patterns and practices. As part of a recent non-targeted prepayment review of the agency's private duty nursing claims, several inconsistencies between clinical practice and the New York State Private Duty Nurse Provider Manual were noted. A sample of the findings from several records, with patient information redacted, is presented below to ensure you understand areas where improvement is needed going forward.
If you have any questions regarding expectations, please contact the Director of Clinical Services for your branch immediately. You may also use the form below to contact our VP - Patient Services. Thank you!