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STRATEGIES TO SUPPORT THE INTEGRATION OF MENTAL HEALTH INTO PEDIATRIC PRIMARY CARE
STRATEGIES TO SUPPORT THE INTEGRATION OF MENTAL HEALTH INTO PEDIATRIC PRIMARY CARE

... While there are barriers to overcome, policymakers, providers and health plans can take a number of steps to make integration a reality. Changes in both medical school education curricula and continuing education can enhance primary care capacity to provide mental health services. The need for impro ...
Core Set of Health Care Quality Measures for
Core Set of Health Care Quality Measures for

... Section 2703 of the Affordable Care Act (Public Law 111-148), entitled “State Option to Provide Health Homes for Enrollees with Chronic Conditions,” creates a new opportunity for states to support improved integration of care for individuals with chronic conditions. Through the establishment of sect ...
Health Home Core Set Manual
Health Home Core Set Manual

... Section 2703 of the Affordable Care Act (Public Law 111-148), entitled “State Option to Provide Health Homes for Enrollees with Chronic Conditions,” creates a new opportunity for states to support improved integration of care for individuals with chronic conditions. Through the establishment of sect ...
N.J.A.C. 10:57 - State of New Jersey
N.J.A.C. 10:57 - State of New Jersey

... be on the basis of the customary charge, not to exceed a fixed fee schedule determined reasonable by the Commissioner, Department of Human Services (see N.J.A.C. 10:57-3 for fee schedule), and further limited by Federal policy relative to payment of practitioners and other individual providers. In n ...
Policy - Global Benefits Group
Policy - Global Benefits Group

... The declarations of the Policyholder and eligible dependents in the application serve as the basis for the policy. If any information is incorrect or incomplete, or if any information has been omitted, the policy may be rescinded, cancelled or modified. Any references in this Policy to the Policyhol ...
Slide 1
Slide 1

... dental clinic referrals; these forms were not updated Referral forms were not completed uniformly by the referring case ...
Small Business Solutions Florida Dental Benefi ts and Insurance Plan Options
Small Business Solutions Florida Dental Benefi ts and Insurance Plan Options

... employers can now afford to offer their employees the luxury of choice. Administration is easy and members benefit from low group rates and the convenience of payroll deductions. With the Voluntary Dental option, employers choose how the plan is funded. It can be entirely member paid or employers ca ...
new york state fee schedule for dental services
new york state fee schedule for dental services

... insure their compliance with existing Medicaid policy. Providers submitting fee for service claims for the “professional component” of services provided in an approved Article 28 setting are required to have prior approval. ...
OHS Standard Plan Schedule
OHS Standard Plan Schedule

... * Per unit, up to six (6) units, seven (7) or more units, add an additional $40 per unit. Laboratory processed temporary splint, add an additional $25 per unit for seven (7) or more units. Co–payments: 1. Members are eligible to receive any listed covered service on this benefit schedule when it has ...
Operational Guidelines
Operational Guidelines

... 2.1.3 Standard (capitated) package of oral health services for adolescents A method of funding services where a price is paid per annum for a prescribed list of treatment (see section E5.1 of the CDA) for each enrolled patient. The price covers a range of services from which a provider can choose th ...
Volusia County School District
Volusia County School District

... DeltaPreferred Option (DPO) is Delta’s preferred provider program. The program provides the maximum benefit when you visit a DPO dentist. DPO dentists are Delta dentists who have agreed to charge DPO patients reduced fees. To use your DPO program, just call the dental office and verify that the dent ...
Dental care services for elderly in Hong Kong
Dental care services for elderly in Hong Kong

... December 2016 Elders are the most financially vulnerable group in Hong Kong, with one in three living in poor households in 2015. Poor elders lack the ability to meet many of their basic needs, including the dental care services that are largely provided by non-governmental organizations and the mor ...
Guideline on Periodicity of Examination, Preventive Dental Services
Guideline on Periodicity of Examination, Preventive Dental Services

... or skeletal dysplasias occur.26 Early dental visits provide an opportunity to encourage parents to help their children stop sucking habits by age three years or younger. For school-aged children and adolescent patients, counseling regarding any existing habits (eg, fingernail biting, clenching, brux ...
13 Dentist - American Academy of Pediatric Dentistry
13 Dentist - American Academy of Pediatric Dentistry

... Dentist Certain dental health care services are available for eligible children as part of the Early and Periodic Screening, Diagnosis, and Treatment up to age 21 as long as the child remains eligible for Medicaid. Most children cease to be eligible upon reaching their 19th birthday. Dental services ...
The AAP policy statement on Oral Health Risk Assessment
The AAP policy statement on Oral Health Risk Assessment

... filling materials) in any primary tooth of a child 71 months of age or younger (age 0-5).4 In the United States, tooth decay is the most prevalent chronic disease of childhood, five times more common than asthma.11 For the period of 1999-2004, 28 percent of 2-5 yearolds have experienced tooth decay. ...
Care Coordination for California`s Children and Youth with Special
Care Coordination for California`s Children and Youth with Special

... chronic physical, developmental, behavioral, or emotional condition that requires more than routine health and related services.1 These children and their families face myriad challenges: coverage and access to needed pediatric specialists can be inadequate or inconsistent, and navigating the variou ...
Understanding Legal and Regulatory Provisions that Impact Your
Understanding Legal and Regulatory Provisions that Impact Your

... Therefore, if a supplier desires to open up a mail order respiratory pharmacy, then it must assume financial risk and operational responsibilities in operating the pharmacy, Likewise, if a hospital contracts with a supplier for management services for the hospital's DME operation, then while the sup ...
UnitedHealthcare® Options PPO 20/covered dental services
UnitedHealthcare® Options PPO 20/covered dental services

... for a particular condition will not result in coverage if the ...
Telehealth in State Substance Use Disorder (SUD
Telehealth in State Substance Use Disorder (SUD

... Center for Substance Abuse Treatment (CSAT).  Jaclyn Sappah served as the principal author with  support from Rick Harwood (NASADAD).  ...
Global Benefits Group, Inc
Global Benefits Group, Inc

... actively attend classes. The Company maintains its right to investigate eligibility or student status and attendance records to verify that the policy eligibility requirements have been met. If the Company discovers that the policy eligibility requirements have not been met, its only obligation is t ...
New York State - NYS Council for Community Behavioral Healthcare
New York State - NYS Council for Community Behavioral Healthcare

... residential option in the community. Services should address the beneficiary’s major lifestyle, interpersonal, attitudinal, and behavioral problems that have the potential to undermine the goals of treatment. Residential SUD services include medically necessary care according to assessed needs inclu ...
IdealCare Member Handbook
IdealCare Member Handbook

... health, vision care, prescription drugs, emergency care, durable medical equipment, dietary formulas necessary for the treatment of phenylketonuria (PKU) or other heritable diseases, amino acid bases elemental formulas, acquired brain injury treatment, treatment for Autism Spectrum Disorder, diabete ...
Medicaid Managed Care Best Practices Compendium
Medicaid Managed Care Best Practices Compendium

... • Outreach support throughout their treatment regimen. Registered nurses (RNs) initiate outreach to establish a relationship, gather health data, and assess adherence risks based on responses to questions in the health plan’s proprietary tool. Outreach continues on a weekly basis for the first five ...
Chapter 6: Physician and Professional Services
Chapter 6: Physician and Professional Services

... (RTCs) providing inpatient services to members currently receiving Medical Assistance (Medicaid). Investigative: Refer to Authorization Standards for Surgery, Including Cosmetic and Reconstructive Surgery section of this chapter. Long-Term Care Consultation (LTCC) Screening Document: An assessment t ...
FREE CLINIC CARILION PEDIATRIC DENTAL PROGRAM
FREE CLINIC CARILION PEDIATRIC DENTAL PROGRAM

... of patients who are self pay or have private dental insurance. Appointments. It is important to be mindful of your patient population when establishing appointment policies. After trying a number of approaches, a great reduction in the no-show rate was achieved by making appointments (excluding six- ...
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EPSDT

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is the child health component of Medicaid. Federal statutes and regulations state that children under age 21 who are enrolled in Medicaid are entitled to EPSDT benefits and that States must cover a broad array of preventive and treatment services. Unlike private insurance, EPSDT is designed to address problems early, ameliorate conditions, and intervene as early as possible. For the 25 million children enrolled in Medicaid and entitled to EPSDT in 2012, the program is a vital source of coverage and a means to improve the health and well-being of beneficiaries.While a small number of cases and anecdotes regarding high EPSDT costs have garnered public attention, spending per child is low compared with worker-age adults and seniors covered by Medicaid. This is true despite the breadth of coverage provided to children through EPSDT. Children account for approximately half of Medicaid beneficiaries but only roughly 20-25 percent of the costs of the program overall. With Medicaid and EPSDT, however, poor children's access to health care is similar to that of non-poor, privately insured children and child Medicaid beneficiaries use care in approximately the same pattern as their privately insured counterparts. On average, Medicaid costs per child are less than private insurance.
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