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Thank you for participating in the Optum™ Patient Assessment Form (PAF) program/Healthcare Quality Patient Assessment Form (HQPAF) program. Your Optum team appreciates how hard you all work to make sure each of your patients is seen at least once per year. As we are nearing year end, we would like to take a moment to provide you with some tips to ensure you are maximizing your PAF/HQPAF returns.
Now is a good time to review your list of patients who were part of your 2015 PAF/HQPAF program and follow any guidance you received from Optum’s health plan clients as to prioritizing tiers of that health plan’s membership.
Check the names of the patients remaining on your list. If there are patients who have not yet been seen this year and are not scheduled for an appointment please take the opportunity now to get an appointment scheduled by the end of the year. You should also consider following up with patients you have referred for health maintenance screenings to ensure that they plan to complete the screenings or services that are scheduled. Your Healthcare Advocate can provide you with a report that will identify what patients still need to be seen and what quality gaps may still exist and need to be closed by the end of the year. If you are unable, or unwilling to schedule an appointment with the patient, please return the PAF with the Patient Status Exceptions section completed, indicating why an assessment could not be performed for that patient.
- Be sure that all of your completed PAF’s/HQPAF’s have been received by Optum and include all necessary information to be considered complete. If a form has been rejected due to missing information you have the opportunity to correct and re-submit that patient form.
- Do not hold onto a completed PAF/HQPAF. PAFs/HQPAFs should be submitted with all the necessary information as soon as it is complete. This will ensure that we do not experience a backlog in processing and allow for us to inform you of quality gaps that may still exist.
- If you have already submitted an HQPAF on behalf of a patient and have new information you would like to send to Optum please check with your Healthcare Advocate to determine if a supplemental HQPAF is available.
- Supplemental HQPAFs are an opportunity for providers to close new and/or existing risk or quality gaps after you have submitted an HQPAF for a patient. Not every patient will have a supplemental HQPAF produced.
We appreciate all of your hard work and thank you for all you have done so far this year. If you have not started to submit completed PAF/HQPAF forms it is not too late to begin. Please contact your Healthcare Advocate right away for assistance in getting started.
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. and 4:30 p.m. PST, Monday–Friday, 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.
As of January 1, 2016, all providers that qualify for HQPAF/PAF administrative reimbursement must receive their reimbursement via direct deposit. In 2016, administrative reimbursement will be completely paperless and checks will no longer be available. To ensure that you do not experience delays in 2016 payments, please visit optum.com/hqpaf or contact Electronic Payments & Statements (EPS) directly at 1-877-620-6194 to enroll.
Remember, all PAF/HQPAF submissions must be sent via traceable carrier (any commercial carrier with traceable delivery) to the following address:
Optum
Prospective Programs Processing
7105 Moores Lane, Suite 200
Brentwood, TN 37027
Effective 1/1/2016, mail will no longer be picked up from the old address in Franklin, TN. Any mail delivered to the Franklin, TN address will not be received by Optum.
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
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