What Therapists Need to Know About the Optum Patient Summary Form (PSF)
With the upcoming changes to UnitedHealthcare clinical submission requirements and AARP Medicare Advantage therapy update, starting September 1, 2024, our workflow as therapists will undergo significant adjustments. For certain [Medicare Advantage therapy updates 2024 enrollees, we will be required to submit an online Optum Patient Summary Form (PSF). While this update aims to streamline documentation, it also introduces new challenges that we need to prepare for.
What’s Changing
Beginning in September, we will be required to submit a PSF online for specific UnitedHealthcare and AARP® Medicare Advantage® members. The good news is that this does not apply to initial evaluations, but Optum PSF submission process will be mandatory for all follow-up treatment visits, including those already in progress.
Why the Optum Patient Summary Form (PSF) Matters
Optum Health uses this information to assess patient eligibility and enter data into their Clinical Information System. This form is also crucial for supporting clinicians to evaluate our treatment approach, ensuring that the care we provide aligns with patient needs.
How to Complete the PSF
We are encouraged to complete and submit the PSF online through the Optum Health portal at www.myoptumhealthphysicalhealth.com. Tutorials and instructions are available to guide us through the process. If internet access is an issue, the form can be faxed and here are Key points to remember:
- Document the Start Date: Clearly indicate the start date for the treatment episode.
- Identify the Provider: Fully complete the section that identifies you and your practice location.
- Credential Information: Make sure to include your credentials as the provider performing the service.
You can also contact Optum Provider Services if you have questions or further clarifications about this update. You can call them at 1-800-873-4575.
Understanding the Impact
While this update aims to make our documentation more efficient, it is understandable that there are concerns. Here is what we need to know and prepare for:
Compliance and Penalties
If we do not comply with these new UnitedHealthcare clinical submission requirements, we could face delayed payments, claim denials, or other penalties. It is vital that we submit the Patient Summary Form (PSF) on time and accurately to avoid any disruptions in reimbursement.
Impact on Reimbursement
Our reimbursement is directly tied to how timely and accurately we submit the PSF. If we miss the deadline or make errors in the submission, we risk delays or denials in payments, which could impact the financial health of our practice.
Clarification on Scope
The Optum PSF submission process applies to every treatment plan, regardless of how long it’s been in place. This means we need to submit a PSF for every follow-up visit, not just those that exceed a certain number of visits.
Deadline for Existing Treatment
As of this writing, there is no specific deadline for submitting the PSF for patients already receiving treatment before September 1st. We will update this article as soon as more information becomes available. Please stay tuned for further updates to ensure uninterrupted care.
Alternatives for Offline Submissions
While the online submission is preferred, we can fax the forms if necessary. Currently, there are not any other offline submission methods, so we will need to make the most of the available resources to stay compliant.
Increased Administrative Burden
Introducing the PSF adds another layer of documentation, which means more time spent on administrative tasks. This can take away from the time we have for direct patient care, so we will need to find ways to efficiently integrate this requirement into our workflow.
Adapting to the Changes
With the September 1st deadline approaching, it is important that we stay informed and support one another through this transition. Understanding these new requirements is just the first step and our collective effort will ensure we continue delivering high-quality care.
How To Effectively Prepare and Adopt to the Upcoming Changes
Adapting to new clinical submission requirements can be challenging, but with the right strategies, we can navigate these changes smoothly, mitigate the risks and ensure we remain compliant.
Here are Some Strategies You Can Use to Prepare:
- Collaborative Documentation: Share knowledge and best practices within your team to ensure everyone understands the new PSF submission process. Regular team discussions can help address any uncertainties and keep everyone aligned.
- Access to Resources: Ensure your team has easy access to tutorials, guidelines, and support materials that explain the new requirements. Regular training sessions can also help reinforce the correct procedures.
- Staying Compliant: By setting up reminders and establishing a thorough review process, we can reduce the risk of missed or incorrect submissions. This proactive approach will help us avoid any penalties or disruptions to patient care.
With the added documentation requirements, it’s important to leverage tools that can ease the process. EMR systems like HelloNote can help you adapt to these changes quickly. You can post regular reminders to your team through HelloNote EMR as frequently as needed so that everybody in your team is fully aware during the implementation phase until such a time that everyone is well acquainted with the new process.
HelloNote also offers features that specifically address the challenges posed by the new submission requirements. For example, it includes an option to add authorization numbers with a date range and number of visits, notifying providers and staff when authorizations are about to expire or when the number of authorized visits has been exceeded. Additionally, HelloNote provides a report for expired authorizations, making it easier to manage and track patient visits within the required limits.
EMRs can streamline the documentation process. It can help you integrate filling out Optum’s Patient Summary Form in your workflow and proceed with online submission smoothly. This will ultimately reduce the administrative burden and allow us to focus more on our patients.
These changes are significant, but by staying informed, with the collaborative support of our team, and using the right tools, we can adapt faster and continue to provide the best care for our patients. After all, we became Therapists not just for the money but most of all because we care!