Part B Portal Enhancements Training My care Ohio

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Overview of Portal Upgrade Extra layer of security by registering for a system license Efficient way to enter therapy information, including multiple therapies for one member at a time. –For NP to continue to write the orders Streamlines the therapy referral process Direct link to clinician for therapy requests Quick access to member goals and progress for facility and provider Maximizes time spent with patients for care More effective collaboration between Optum clinician and therapy department to manage the care of the member More efficient way of submitting valid information to health plan to avoid denials on the back end. –Health Plans will be doing random reconciliations of claims for validation

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Which patients should be entered in portal? This portal will include MyCare Ohio Opt-In patients for Centene and C&S only (fully integrated Medicare members) MyCare Medicaid Only members are Opt-Out and therefore, need to go directly through the Health Plan Optum ISNP Members and Aetna cannot be entered into portal. Continue current process Collaborate with your Optum Clinician for questions

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. First Time Users – Registering for access Click on this site: New Users: - To access the community click request an account - If already a community member then can use login credentials to login.

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Complete form for registration The user submitting request should fill out all options as they are made required except extension field. The user cannot use same id more than once for applying because when request submitted for first time with any particular ed, the user will be created with that particular id in the system and salesforce will not allow two users wit same id. Once user is finished with the submitting a thank you screen will be appear Note: Licenses are for Therapy Managers. 1 license per facility (will be reviewed on case by case basis as needed)

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Portal Access: The portal can be accessed through the direct link below - Save this link to your favorites – you can continue to log in as needed utilizing your new username and password

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. What do I do once I access the portal? Pick the HealthPlan, associated with the resident, from dropdown box and click “next” to the far right of your screen Aetna is not applicable

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Therapy referral process – Centene (Buckeye) Step 1- Centene (Buckeye): Enter resident’s Medicaid ID number Step 2- Click on next button to the right

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Step 1- OH C & S (UHC) Enter resident’s HealthPlan ID number (found on back of card or on face sheet) Step 2- Click on next button to the right Therapy referral process – UHC – (OH C&S)

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Therapy referral process – NEW REFERRAL Create new referral click the radio button that says Create New Referral Click on: Create New Referral - then hit Next

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Therapy referral process – NEW REFERRAL Cont’d. Confirm that Name, DOB, and facility are correct. (if any information is inaccurate please contact your clinician) Step 1- Enter Date and Optum Nurse practitioner name Step 2- Click on next

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Therapy referral process – UPDATE EXISTING Update an existing referral To update an existing referral click the radio button next to the initial request that you submitted. – please note that each request is identified by the member last name, DOB, initial date of request, and therapy requested. You will need to click on the radio button of the Existing initial request to update

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Screen will look like this (New & Existing) Note: For an existing member, all information will be populated – please revise for any changes Red fields are mandatory

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Therapy referral process Enter PT, OT, or ST. (each discipline will require a separate entry) Enter the name of the therapist-required Therapist - REQUIRED –NOTE: Approvals are sent to this address Therapist NPI Required Facility TIN Required Facility Office manager -enter here if you would like the office manager notified

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Mandatory information not completed Please note: If you attempt to move forward without completing mandatory information, you will receive an error notice: (below)

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Therapy referral process Enter a description of resident’s baseline (can be copy/pasted from therapy plan of treatment into corresponding box) What was the change from baseline that initiated this therapy? What are the short term goals of therapy? Include guideline and time frames for goals. Diagnosis code: Please use medical Diagnosis code. Cannot use Vcodes.. Update week: Therapy may be written for a maximum of two weeks at a time by the Optum NP,. If goals are expected to exceed two weeks, a review date must be entered If an end date is anticipated within the two week timeframe, please enter the end date in the designated end date box Please remember to enter either a review date or an end date in the appropriate box Reminder- when you receive an approval from the NP, note the reference number (located in the subject line of the )

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. CPT Code Input You will choose the CPT code you need and drop down to choose number of visits for that CPT code (up to 10 visits) FIRST CPT CODE IS MANDATORY If you only need one CPT code: - click on No below then hit next If you need multiple CPT Codes: - click on Yes below then hit next

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Multiple CPT Code Input Continue this same process for up to 10 CPT Codes Once you have put in all CPT Codes: - click on No below then hit next

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Therapy referral process Last page will have this message: Thank you. Your request has been submitted for review by Optum NP/CM ( Name of the NP/CM will be here). Click on finish to the far right. Your request for confirmation will be sent to the provider that you identified. Note: Once Optum NP confirms medical necessity, you will receive an