Get Ma Psf-1 2010-2025

The MA PSF-1, or Physician Summary Form, is an essential document for verifying medical information for patients seeking MassHealth services. Understanding how to accurately complete this form is crucial for ensuring timely access to healthcare.

Follow the steps to effectively complete the MA PSF-1 online.

1. Press the ‘Get Form’ button to access the MA PSF-1 and open it in your document editor.
2. Begin by filling in the patient's last name, first name, and date of birth in the appropriate fields. Ensure that all provided information is accurate and legible.
3. Select the patient's gender by marking either 'F' for female or 'M' for male.
4. In the diagnosis section, document the relevant diagnosis or diagnoses. Be specific and indicate any mental illness, intellectual disability, or developmental disability as applicable.
5. List the treatments being provided to the patient, including specific medications. Utilize the back of the form if more space is needed for additional medications.
6. Provide details about skilled therapy services, including direct therapy by occupational therapy (OT), physical therapy (PT), or speech therapy (ST) as necessary.
7. Fill in the patient's recent vital signs. Include the date and record temperature (T), pulse (P), respiration (R), and blood pressure (BP).
8. Indicate any known allergies. If the patient has allergies, list them clearly. If there are no known allergies, check the appropriate box.
9. Record the patient's height and weight, ensuring that this information is up-to-date.
10. Provide details regarding continence for bowel and bladder, marking whether the patient is continent, incontinent, or has a colostomy or catheter.
11. Document the mental status of the patient, selecting from the options: alert and oriented, alert and disoriented, or other.
12. Include the date of the last physical exam and the date of the last office visit.
13. Indicate the recommended services for the patient, selecting all that apply, such as adult day health, group adult foster care, adult foster care, or nursing facilities.
14. Finally, certify the accuracy of the information provided by signing the form. Print your name and address, and include your status as MD, NP, or PA, circling the correct designation. Ensure the date of completion is noted.
15. Once all sections are complete, save changes to the document. You can choose to download, print, or share the form as needed.

Start filing the MA PSF-1 online today to ensure your patient receives the necessary services without delay.