If you do not see the images in this email, click here to view.

Optum
Patient Assessment Form (PAF) and Healthcare Quality Patient Assessment Form (HQPAF)
Closing out 2017

Optum strongly encourages providers to outreach to their members as a last opportunity to get them scheduled for visits by the end of the year in order to manage those important chronic conditions which impact the health status of the patient. Some patients prefer to wait until the last month of the year to get their Annual Wellness Exams performed, but we recommend you review your patient population to identify any patients who still need to be seen and outreach to schedule those appointments. Please keep in mind …

Dates to Remember:
  • As you continue to prospectively complete your 2017 forms, there are some important dates to remember:
    • 2017 HQPAFs/PAFs expire on 12/31/2017
    • Forms can be submitted through 01/31/2018 with a 2017 Date of Service (DOS)
    • Rejected forms can be submitted through 03/30/2018 with corrections and a 2017 DOS
  • The 2017 HQPAFs/PAFs will remain available via OPAF and InSite until the 2018 Program year begins (on or around 02/09/18). You may continue using the 2017 HQPAFs/PAFs to submit patient encounters that took place on or before 12/31/2017.
    • Tip: Do not use the 2017 HQPAFs/PAFs to submit 2018 DOS! 2017 HQPAFs/PAFs submitted with a 2018 DOS will be rejected. Please hold 2018 encounter submissions until the 2018 forms become available (on or around 02/09/19).
  • If you have not already done so, please be sure to submit an Account Setup Form (ASF), W9, and complete your direct deposit enrollment. Submission of ASF, W9 and direct deposit enrollment are due by 03/30/2018.
Did you know …

 Your Optum Healthcare Advocate or the Provider Support Center can provide access to a number of tools to assist you in tracking your participation in the program. Please contact your Healthcare Advocate or Optum’s Provider Support Center at 877‑751‑9207 or via email at providersupport@optum.com with any questions.

To minimize errors, or to correct previously rejected forms, please refer to the HQPAF Checklist and FAQ for Providers.

Remember …

PAF/HQPAF must be
submitted via:

• Traceable carrier (any commercial carrier with traceable delivery) to the following address:
Optum – Prospective Programs Processing
15458 North 28th Avenue, Suite G
Phoenix, AZ 85053
• PAF Uploader: please visit optumupload.com
• Secure Fax:
1‑877‑889‑5747
  • Failure to comply with these requirements will result in automatic forfeiture of administrative reimbursement for all 2017 HQPAFs/PAFs, if applicable.
    Note: Submission of an ASF, W9, and direct deposit enrollment is not required for any groups that are already receiving HQPAF/PAF administrative reimbursement. This message only pertains to those who have payments pending. If you are unsure if you have pending payments, please contact your Healthcare Advocate or call the Optum Provider Support Center at 1-877-751-9207.
Quality Gaps Year-End Tips:
  • Measure compliance for "Control Measures" such as Diabetes HbA1c control and Controlling Blood Pressure are based solely on the last reading of the year, please note:
    • About 15% of medical records submitted with evidence of blood pressure readings had results that did not meet compliance levels and did not close the measure gap.
    • About 30% of medical records submitted for the HbA1c screening and control measure only had an indication of the member being referred for a lab screening without any results and thus not closing the gap.
    • About 15% of medical records submitted for Diabetes HbA1c control and 2% for Controlling Blood Pressure measures did not contain measure information on the medical record and did not close the gap.
  • There is still a chance to make an impact — please continue to submit evidence of completed screenings.
Provider and Roster Changes
                  Did you have providers who left your practice this year?
                  Did you have providers who joined your practice this year?
  • It is important to keep an accurate roster of all new and deleted physicians and mid-level providers in your practice and the membership associated with those providers. This is a great time of the year to stop and review the accuracy of your roster prior to Optum’s deployment season. Now is the time to make any necessary adjustments prior to sending to your healthcare advocate. This will ensure the accuracy of your membership and avoid duplicate Patient Assessment forms or inaccurate provider attribution. If you have any questions about the roster, please reach out to your Healthcare Advocate.

2018 and beyond

Provider and Staff Trainings
  • Reach out to your Healthcare Advocate to learn more about training opportunities available through Optum and work to get those scheduled. Provider groups have the option to attend the monthly WebEx training provided by Optum, or can work with their Healthcare Advocate to develop specific agenda topics to customize individualized training. Your Healthcare Advocate will bring leave behinds to use as ongoing coding and documentation tools. We also encourage you to work directly with your Healthcare Advocate to determine the training schedule for 2018 so you can take advantage of these great training opportunities.
HQPAF/PAF annual provider survey
  • Please note the HQPAF/PAF annual provider survey will be taking place in January 2018. We encourage your participation on this online survey and welcome your feedback on the HQPAF/PAF program. The information learned in the survey will be considered in the design of future iterations of the program.
Thank you for your cooperation and participation!
If you have any questions about the PAF or HQPAF programs, please contact your local Optum Healthcare Advocate or the Optum Provider Support Center between 6:30 a.m. – 4:30 p.m. PST, Monday – Friday (excluding weekends and holidays), at 1‑877‑751‑9207 or email us here.

Thank you again for your participation in the Optum Patient Assessment Form (PAF) and the Healthcare Quality Patient Assessment Form (HQPAF) programs.

Effective immediately, we encourage you to use our new HQPAF/PAF Uploader; an easier and faster submission method. The HQPAF/PAF Uploader requires less time and effort than preparing and submitting documentation via mail or fax.

The HQPAF/PAF Uploader was developed to provide an interface that allows multiple users to securely submit HQPAFs/PAFs without issue of failed delivery or suspended access. The HQPAF/PAF Uploader:
  • Does not require any user credentials
  • Complies with all HIPAA guidelines to protect your practice and your patient’s personal data
  • Allows anyone in your office to access the site and upload documentation
  • Securely transmits directly to Optum
To get started, please visit: optumupload.com.

For additional information as well as publications and products available for HEDIS®, please visit the National Committee for Quality Assurance (NCQA) website at ncqa.org.

For additional information about the Medicare Advantage Five‑Star Quality Rating System, please refer to: http://go.cms.gov/partcanddstarratings.

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum.
This message was sent by Optum™ | 11000 Optum Circle, Eden Prairie, MN 55344 USA | 1‑866‑306‑1317 | information@optum.com | www.optum.com | © 2017 Optum. All rights reserved.

This promotion was sent to <>. No Thanks. Your request to decline future email will be honored by Optum.
Opt out: click here.