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The following is a FAQ developed by ACN to address questions regarding the Clinical Support Program. I hope you find this helpful.
Angela S. Brooks, PT
VPTA Payer Relations Specialist
Q: Where may I obtain additional information about ACN Group's Clinical Support Program?
A: You may obtain additional information regarding ACN Group's Clinical Support Program by accessing your:
- ACN Group Plan Summary
- ACN Group website, WebAssist, www.acnprovider.com
- ACN Group Operations Manual
- ACN Group Member-Provider Service Representative for administrative information
- ACN Group Support Clinician for clinical information
Q: Who is my Support Clinician and how do I reach him/her to discuss clinical issues?
A: ACN Group has clinicians located throughout the
Q: I hear about the ACN Group website/"my website"/WebAssist repeatedly. How do I access this site and why should I use this site?
A: The ACN Group provider Web site, WebAssist, provides a wealth of information. You may access WebAssist by launching Internet Explorer on your browser, typing www.acnprovider.com into the URL, and entering your ACN Group provider ID and Web site password. If you do not have a provider ID and password, you may contact an ACN Group Member-Provider Service Representative who will provide you with one.
WebAssist offers a variety of useful tools and information including:
- Your provider profile
- A direct link for submission of ACN Group Patient Summary Forms
- A link to view Patient Summary Form submission status
- A link to view claim submission form status
- A link to submit a claim
- Clinical resources to include tutorials, commonly used forms, newsletters, and policies
Q: I am frequently encouraged to use the "online format" for Patient Summary Form submissions. Why should I submit a Patient Summary Form online rather than submit it via facsimile?
A: One of the benefits of electronic Patient Summary Form filing is that the system will not accept the Patient Summary Form unless it is filled in completely. This will immediately reduce errors and process delays. Facsimile submission of incomplete Patient Summary Forms can increase processing time. Another benefit to submitting a Patient Summary Form online is that once the Patient Summary Form is successfully submitted you will receive a confirmation number. You may print out the confirmation page or copy down the confirmation number. Receipt of the confirmation number lets you know that your Patient Summary Form has been received by ACN Group. When you submit your Patient Summary Form online, you have the added ability to view the status of your online submission.
Q: My office staff calls UnitedHealthcare for notification and/or preauthorization information. They are frequently advised by UnitedHealthcare that notification and/or preauthorization are not required. After initiating treatment and subsequently submitting claims for reimbursement, we sometimes learn that claims are denied due to non compliance with ACN Group's Clinical Support Program/Utilization Review requirements. Does ACN Group communicate with UnitedHealthcare and visa versa?
A: All clinical submission requirement questions should be directed to ACN Group. You may call the Quick Group Check line at 888-329-5182 or log onto www.acnprovider.com to check the Plan Summary and UnitedHealthcare group check link to verify the need for ACN Group clinical submission. You should call UnitedHealthcare's customer service center for information regarding patient benefits.
Q: Why is my Patient Summary Form submission returned as "late"?
A: A Patient Summary Form submission is considered "late" if it is received later than 10 business days after the start of treatment.
Q: I am treating a patient with two different conditions. When I submit a second Patient Summary Form for the second condition, the first Patient Summary Response is changed to reflect inclusion of the second condition. Why can't I have a different Patient Summary Response for each condition treated?
A: ACN Group expects providers to treat all conditions identified judiciously and simultaneously. If treatment begins with one condition within a given timeframe and ACN Group receives a new Patient Summary Form with a new condition identified, the end date on the initial notification response will be shortened to allow for the start date of the current Patient Summary Form submission.
Q: Why does my Patient Summary Response confirmation number contain letters in addition to the usual number-only confirmation?
A: A Patient Summary Response number that contains letters as a part of the confirmation number indicates that a change in the original Patient Summary Response has occurred. Examples of when you may see this are as follows:
- Change/update in conditions treated
- Change/update in visit value
- Change/update in visit end date value
These types of changes typically occur as a result of additional information provided by your office.
Q: ACN Group does not require that I record functional outcome measures with each Patient Summary Form submission. Why should I implement functional outcome assessment in my clinic and why should I submit functional outcome scores on the Patient Summary Form?
A: Using functional outcome tools in your clinic provides you with ongoing assessment of patient progress with the established treatment plan. Sharing these outcomes with your patient is an opportunity for first-hand continuous feedback. This also provides the strongest documentation for the ongoing need for skilled care. All outcome assessment tools, templates, scoring how-to's, and interpretative education materials are available on the ACN Group Web site, www.acnprovider.com.
Q: Should I review the Patient Health Questionnaire with my patients?
A: Absolutely. When you review the Patient Health Questionnaire with your patients, you improve patient/practitioner communication, goal setting, and barrier recognition. The increase in communication can yield a more positive treatment outcome.
Q: Why should I include information about my patient's surgical procedure and the date of surgical procedure on the Patient Summary Form?
A: Your designated Support Clinician reviews all relevant information in order to apply an appropriate visit/date milestone value to the Patient Summary Response. Surgical procedure and date of surgical procedure information are important components of a patient's health record. Recording these applicable components ensures that your Support Clinician has a full appreciation of the case and all the complexities that may exist due to surgical intervention.
Q: Should my office staff share with me a Patient Summary Response that reads "stationary" or "ineffective"? Should I discuss this transitional type response with my patients?
A: A "stationary" or "ineffective" transitional response on the Patient Summary Response reflects a determination in which a lack of progress is appreciated based on the submitted documentation. These response types should be shared with the treating practitioner, and they in turn provide an ideal opportunity for patient/practitioner discussion about treatment plan, goals, and barriers toward progress. Additionally, should you recognize unique barriers to improvement, you should feel free to contact your assigned Support Clinician for discussion
Q: I have a contract reimbursement question. Where should I direct my question/concern?
A: Contract/reimbursement concerns may be addressed in writing to:
ACN Group Network Management
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