Get Value Optionsmos Form

Completing the Value Optionsmos Form online is a crucial step in ensuring that all necessary information is accurately submitted for prompt processing. This guide provides a clear and supportive overview of filling out the form, catering to users of all experience levels.

Follow the steps to successfully complete the form

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin with the 'Participant Information' section. Enter the participant's last name, first name, and middle initial (MI), followed by their complete address including street, city, state, and ZIP code.
3. Provide the participant's date of birth in the format mm/dd/yy, their home phone number, and ethnicity by selecting one option from the provided list.
4. As indicated, select the appropriate gender of the participant. If the service member is not the participant, include their last name, first name, and MI in the designated fields.
5. Next, locate the 'Billing Information' section and enter the dates of service in the mm/dd/yy format. Be sure to include the authorization number and the type of counseling provided by checking the corresponding option.
6. Fill out the 'MOS Counselor' details including their last name, first name, billing address, phone number, and either their SSN or tax ID number. Additionally, enter the counselor's NPI number.
7. Indicate the total number of sessions billed and provide the counselor’s signature along with the date.
8. In the section titled 'Presenting and Assessed Problem', assess and mark the relevant codes for the participant’s issues.
9. Respond to whether the member has any diagnosis on Axis I or II beyond a V code, and indicate the relationship of the issue to deployment or reintegration.
10. Complete the 'Risk and Functional Assessment' by evaluating the participant’s level of impairment at both case opening and case closing using the defined scale.
11. Proceed to detail counseling goals and assess their completion status.
12. Finally, summarize the case closing disposition and referral type, checking any applicable options before saving your changes.

Complete your documents online now for a smoother process.