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Aetna®* Health Benefit Plans Program Effective Date: 04/ 15/12 Physical and Occupational Plan Summary Rev. 12/01/15 . Claims for this plan are submitted directly . Optum
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IMPORTANT NOTE ABOUT THIS REIMBURSEMENT …
www.myoptumhealthphysicalhealth.comDocumentation Guidelines The documentation in the health care record of a “smoking and tobacco-use cessation counseling or counseling to prevent
Patient Status Report (PSR) - Logon
www.myoptumhealthphysicalhealth.comOptumHealth Care Solutions – Physical Health includes OptumHealth Care Solutions, LLC, ACN Group IPA of New York, Inc., Managed Physical Network, Inc., and ACN Group of …
Patient Status Report (PSR) - Logon
www.myoptumhealthphysicalhealth.comAs patients complete their treatment plans, providers and/or clinical staff record the patient’s final status using the final status categories on the report (note: MTB = maximum therapeutic benefit)
DISABILITIES OF THE ARM, SHOULDER AND HAND
www.myoptumhealthphysicalhealth.comDISABILITIES OF THE ARM, SHOULDER AND HAND DASH INSTRUCTIONS This questionnaire asks about your symptoms as well as your ability to perform certain activities. Please answer every question, based
Neck Index - OptumHealth Provider
www.myoptumhealthphysicalhealth.comNeck Index ACN Group, Inc. Use Onlyrev 3/27/2003 Patient Name Date This questionnaire will give your provider information about how your neck condition affects your everyday life.
PSF-750 Quick Reference Guide - OptumHealth …
www.myoptumhealthphysicalhealth.comOptumHealth Care Solutions – Physical Health includes OptumHealth Care Solutions, LLC, ACN Group IPA of New York, Inc., Managed Physical Network, Inc., and ACN Group of
1. Click the option Yes for Would you like to attach ...
www.myoptumhealthphysicalhealth.comHow to submit attachments to your Clinical Submission. 1. Click the option Yes for Would you like to attach additional documents 2. Attach documents …
Patient Summary Form - OptumHealth Provider
www.myoptumhealthphysicalhealth.comPost-surgical Diagnosis (ICD codes) Please ensure all digits are entered accurately Current Functional Measure Score Patient Summary Form PSF-750 (Rev: 7/1/2015)
NEW PATIENT VISIT CPT Code 99201 99202 99203 …
www.myoptumhealthphysicalhealth.comNEW PATIENT VISIT CPT Code 99201 99202 99203 99204 99205 Required Key Components *(3/3 required) History and Exam Problem-Focused X …
IMPORTANT NOTE ABOUT THIS REIMBURSEMENT …
www.myoptumhealthphysicalhealth.com3 98943), “The chiropractic manipulative treatment codes include a pre-manipulation patient assessment. Additional Evaluation and Management services may be reported separately using the modifier -25, if the patient’s condition requires a significant separately
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