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PSF-750 Quick Reference Guide - OptumHealth …

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. R EVISED : 07/01/2015 OptumH eal th Physi cal H eal th. UM D Quick Reference GuideHave your pa tie nt complete:xPa tie nt se ction andxFunctional outcome measure (recommended, but not required)The provider billing for services should complete the remainder of the Patient Summary Form must be received by OptumHealth no later than te n (10) days from the submission start date. The Patient Summary Form can also be submitted online at further process details, please view the tutorial at patient demographic informationIndicat e t he pat ient type for THIS submissionNature of patient s condition for THIS episode(Chiropractic use only)Indicat e ant icipat ed CMT levelPat ient complet es t his sect ion.

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

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