Myoptumhealthphysicalhealth.com

Welcome to WebAssist

demographics, either name, address, health insurance plan, or any item, complete a new submission, include the new information as you would for a new patient. • Once the PSF is processed the patient’s name with the new information will show up on the patient list.

Actived: 7 days ago

URL: myoptumhealthphysicalhealth.com

OptumHealth Provider

Northeastern Regional Office Health Plan: Address: Phone: Fax: Aetna P.O. Box 1669, Kingston, NY 12402 (888) 329-5180 (845) 383-0074

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Welcome to WebAssist

demographics, either name, address, health insurance plan, or any item, complete a . new submission, include the new information as you would for a new patient. • Once the PSF is processed the patient’s name with the new information will show up on the patient list.

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Patient Summary Form

Post-surgical Diagnosis (ICD codes) Please ensure all digits are entered accurately Current Functional Measure Score Patient Summary Form PSF-750 (Rev: 7/1/2015)

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Welcome to WebAssist

Welcome to WebAssist- For Humana Providers (pages 24-46) Learn How to Submit PSF-750 online Welcome to WebAssist - Optum Provider Portal (pages 1-23)

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ClinicalPolicies

Home; UM Program; UM Program (California only) Clinical Policies #

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ClinicalPolicies

The materials provided to you are guidelines used by this plan to authorize, modify, or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract. Please select one of the Clinical Policy's presentation views from the menu.

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Retrospective Review and Voluntary Prior Approval Process

OptumHealth Care Solutions – Physical Health includes OptumHealth Care Solutions, LLC, ACN Group IPA of New York, Inc., Managed Physical Network, Inc., and ACN Group of California, Inc. REVISED: 10/13/10 ©2010 OptumHealth Care Solutions – Physical Health. UM Dept. 1 Retrospective Review and Voluntary Prior Approval Process

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Clinical Submission Process Guide

4 begin.” Submit to OptumHealth Physical Health via: x Internet: x Fax: x Mail: www.myoptumhealthphysicalhealth.com (registration and assistance available at: (888) 676-7768 ext. 6632) 248-733-6070 for UnitedHealthcare clinical submissions OptumHealth Physical Health regional office indicated on your Plan Summary

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Maximum Therapeutic Benefit

that included independent health care practit ioners. Utilization Management Policy *Optum is a brand used by OptumHealth Care Solutions, LLC and its affiliates 2 . What did the work group find? • Most individuals can expect to notice measurable improvement in pain and/or disability

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Patient Billing Acknowledgement Form Non-Covered Services

REVISED: 10/14/10 ©2010 OptumHealth Care Solutions – Physical Health. UM Dept. 2 Patient Billing Acknowledgement Form Maintenance/Elective Care** Under your health plan, you are financially responsible for co-payments, co-insurance or deductibles for covered services. You are also financially responsible for all non-covered

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Application to Appeal a Claims Determination

Health Care Provider Application to Appeal a Claims Determination Submit to: OptumHealth Care Solutions – Physical Health. If by mail, at: PO Box 5800 Kingston, NY 12402-5800. If by courier service, at: 505 Boices Lane, Kingston, NY 12401 You have the right to appeal Our claims determination(s) on claims you submitted to Us.

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Texas Medicaid Pediatric Supplement to the PSF–750

Current TX Health Steps (THSteps) Date Provider Information Patient Information Referral/ Date Plan of Care Certification Date (Most Recent) Peds Sup to PSF-750 Version: 4/26/2018 Specialty or Service being requested (please select only one) OT PT ST Physical Therapy Contact: Name of the evaluating and/or treating physical therapist and phone

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IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY

reasonable discretion in interpreting and applying this policy to health care services providedin a particular case. Further, the policy does not address all issues related to reimbursement for health care services provided to Client enrollees. Other factors affecting reimbursement may supplement, modify or, in some cases, supersede this policy.

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OptumHealth Provider

Brennan McNally has been with OptumHealth since December 2003 in provider network management roles. Since November 2007 he has served as the Vice President of Network Operations, responsible for network development, maintenance and servicing of OptumHealth’s 70,000+ chiropractic, outpatient therapy and complementary and alternative medicine providers.

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The Keele STarT Back Screening Tool

MN010-W120, PO Box 1459 | Minneapolis, MN 55440-1459 | Toll Free: (800) 873-4575 | Telephone: (763)595-3200 | Fax (763) 595-3333 The Keele STarT Back Screening Tool

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Utilization Management Policy

health agency) • Status (licensure/certification status and DRG exempt status, as needed) • Name • Address • Telephone/Facsimile Number • Tax ID Number or Other ID Number . Utilization Management Policy *Optum is a brand used by OptumHealth Care Solutions, LLC …

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Accessing Your Profile Online PTOT 10.8.12

OptumTM Physical Health [Solutions] (“Optum”) include OptumHealth Care Solutions, Inc., ACN Group IPA of New York, Inc., Managed Physical Network, Inc., and ACN Group of California, Inc. , dba OptumHealth Physical Health of California.

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Performance Benchmarks Tier 1 Advantage Tier 1 Tier 2 Fee …

Optum® Physical Health (“Optum”) includes OptumHealth Care Solutions, LLC., ACN Group IPA of New York, Inc., Managed Physical Network, Inc., and ACN Group of California, Inc., dba OptumHealth Physical Health of California. Revision #: 1 1 Current Revision Date: 3/15/19 Previous Revision Date: 3/5/17 Modified By: V. Feldman

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Utilization Management Program 2019

reasonably required to assess whether the health care services under review meet plan benefit coverage criteria. Acupuncture providers are not subject to the clinical submission requirement at this time for Knox Keene business and/or clients. Prior to submission of the Patient Summary Form, and while the form is being processed, the

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Utilization Management Policy

informed health policy-making is an approach to policy decisions that aims to ensure that decision making is well-informed by the best available research evidence. It is characterised by the systematic and transparent access to, and appraisal of, evidence as an input into the policy-making process.”

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IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY

reasonable discretion in interpreting and applying this policy to health care services provided in a particular case. Further, the policy does not address all issues related to reimbursement for health care services provided to Client enrollees. Other factors affecting reimbursement may supplement, modify or, insome cases, supersede this policy.

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Patient Healthcare Records: Documentation Requirements for …

Other health care organizations and authoritative sources have rendered commentary, reports, and/or enunciated positions/policies concerning standards for record keeping. [28-43] While some of these reports and texts focus upon deficiencies in record keeping, they all describe similar minimum documentation

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IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY

discretion in interpreting and applying this policy to health care services provided in a particular case. Further, the policy does not address all issues related to reimbursement for health care services provided to Client enrollees. Other factors affecting reimbursement may supplement, modify or, in some cases, supersede this policy.

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Provider Resource Guide

providers to have more in-depth knowledge of what drives consumer health care decision-making. Another major driver of change is the Patient Protection and Affordable Care Act of 2010, which brings significant and sweeping changes to how patients, providers, and payers interact, access, and pay for health care. There is increasing

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