UHC PSF (reg patient)

the following steps of submitting a psf is only for patient type; established new condition log into https //www myoptumhealthphysicalhealth com/clinicalsubmissions/index?page=authsubmit# on the drop menu or side menu, select 'submit a clinical sub' next screen will be 'plan' on the left side under patients , select the letter of patient's last name, then on patient's name once established patient is selected, their info should autofill select search to continue patient type there's 4 options, for a patient that schedules regularly select option 4, continuing care date you want this submission to begin the date of their visit clinical information on the drop menu always select hp office address once you select the office location, the webpage will refresh to the psf (patient summary form) auth type submitting for/credentials select dc place of service select 11= office outpatient date you want this submission to begin the date of their visit number of visit(s) within past 90 days either by google or a 'date calculator', calculate what the date was 90 days ago and count how many appointments since that date they've had requested duration in weeks 12 requested number of visits 12 unless said differently per dr mays, we request 12 weeks/visits patient type 4 est'd, continuing care nature of condition 2 recurrent (multiple episodes of < 3 months) also dependant on what dr mays says cause of current episode repetitive anticipated cmt level 98941 diagnosis (icd code) go to patients chart, click on matching date encounter, and write each diagnosis in order as they're listed if there aren't diagnoses in their chart or unsure, get them from dr mays nature of treatment 2 rehabilitative current functional measure score neck index, or back index depending on patient's primary complaint the score is abtained from patient filling out oats form objective measurements identify impairments when they are compared to normal values, the uninvolved contralateral extremity, and prior level of function yes objective assessment of functional ability moderate functional limitations documented plan of care (poc) requiring skilled intervention frequency of treatment visits and treatment activites to address deficit areas symptoms began on date of onset, the day before their scheduled appointment briefly describe your symptoms this will vary and be different for each patient how did your symptoms start? this will vary and be different for each patient average pain/symptom intensity this will vary and be different for each patient these can also be attained from their dc note/oats how often do you experience your symptoms? this will vary and be different for each patient how much have your symptoms interfered with your daily activities? 3 moderately, also will vary how is your condition changing, since care at this facility? 5 a little better, also will vary in general, would you say your overall health right now is 3 good completion date the day your requesting the psf confirm everything that's entered and select the checkbox to be able to submit the psf an alert may pop up of the approval, after reading it select ok near the end of the webpage, select print page and save as pdf (make sure it's in scans folder), 'last name, first the date psf request' go to patient's chart notes and as an alert add how many visits and expiration date ex psf approved 6 visits from 5/14/2025 7/9/2025 lastly, keep track of visits in patient's appointment note as well ex 1/6 psf