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WCH Removed Physician from the OMIG Exclusion List

Tuesday, December 5, 2017

WCH Removed Physician from the OMIG Exclusion List


The Office of the Medicaid Inspector General (OMIG) is an independent entity established within the New York State Department of Health. Its major aim is to promote and protect the integrity of the Medicaid program by preventing and detecting fraudulent and malpractice activities within the Medicaid program while recovering improperly expended Medicaid funds.  

OMIG maintains a list of excluded providers. The list contains providers considered as no longer eligible to participate in the Medicaid program due to license or conduct limitations. Being in the OMIG exclusion list does not allow providers to enroll and participate not only with the State Medicaid program but also with various insurance plans. Providers who are in the exclusion list may be subject to continuous denials of their credentialing applications by state and federal plans. 

Getting off the list can be tricky. Only professional team of consultants can understand the requirements and properly remove the provider off the listing based on the state and licensure regulations. WCH was hired by Dr B to help remove him from the OMIG listing. Several years Dr B used attorney services for this case. Losing trust and hope he gave up. Through word of mouth he was told about WCH Billing and Credentialing services. Dr B hired WCH for this delicate work, and in less than 3 months we achieved long awaited result.  Official letter notifying of removal was sent to provider two weeks ago by OMIG.


WCH has once again won the exclusion case and successfully removed Dr B from the list. Currently, the team is working to restore his enrollment with HMO plans.  


After a detailed review of the history and nature of the problem, professionals of WCH Credentialing Department were confident in their reasoning for removal from the exclusion list. Not only did our team restore Dr B’s wellbeing but also his dignity returning his professional reputation back. The process of removing Dr. B from the OMIG Exclusion List was elaborated and took time with preparing appeal, communication with OMIG and overall waiting period for the decision was tedious. But the end result speaks for itself. 

Our professionalism, experience and individual approach to our clients are what differentiate us from others.

If you had bad experience in the past WCH stands for We Can Help, and that is exactly what we do.


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