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You deliver outstanding care. We help manage administrative tasks and support your staff where they need it most. Learn how Optum partners with physicians to help relieve administrative burdens so they can focus on what matters most: patient care.
In-Office Assessment Program FAQ
The In-Office Assessment Program is a pre-visit and point-of-care program that helps improve patient outcomes. It supports early detection and ongoing annual assessment of chronic conditions for Medicare Advantage (MA), Affordable Care Act (ACA) and Medicaid patients on behalf of health plans.
Optum works directly with providers to administer the In-Office Assessment Program. Easing their workload while gathering information helps improve health plan coverage and get additional resources for complex care.
The Optum program looks at health plan programs through a patient-centered lens. The goal is not only to return assessments. We also provide physicians with the support they need to deliver high-quality patient care and impact positive patient outcomes.
Assessments are pre-populated for each patient based on past claims data, including:
- Primary care visits
- Specialists visits
- Hospitalizations
- Prescription claims
The assessment is designed to be used at the point of care. This helps ensure providers can access complete and comprehensive patient data. We encourage physicians to review the assessment before or during the patient’s office visit to help assess and address any care opportunities.
Proper documentation in the medical record must support all diagnoses confirmed during the encounter and screenings completed or referred.
Optum understands how valuable your time is. That’s why we offer administrative reimbursement to physicians for accurately completing and submitting In-Office Assessment Program material with supporting medical documentation.
As part of the In-Office Assessment Program, physicians and their staff have access to resources and training. Led by Optum healthcare advocates, this includes:
- Issue resolution and workflow consulting
- Coding and documentation training
- Additional reporting and program support
Optum representatives can also assist with patient outreach and appointment follow-ups to help increase medication compliance and scheduling referrals.
After the patient visit, compile all medical records showing that any care omissions have been addressed. You can use medical records from all dates of services (DOS) from the current calendar year. If screening documentation falls outside the eligible date range, make sure at least one of the medical records is from an encounter in the current calendar year.
Attach the medical record and all supporting documentation to the completed assessment and submit within 60 days of the latest DOS included. Submit the assessment and supporting documentation via an electronic portal.
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