HUMAN RESOURCES DEPARMENT
... (TRR) approach. Conducts routine and crisis screenings to determine need for psychiatric in-patient hospitalization, admission into Center services, assists in crisis prevention and management by locating and coordinating service and supports. Performs minimally complex social service work and ensur ...
... (TRR) approach. Conducts routine and crisis screenings to determine need for psychiatric in-patient hospitalization, admission into Center services, assists in crisis prevention and management by locating and coordinating service and supports. Performs minimally complex social service work and ensur ...
Rehabilitative Habilitative Services Devices
... sensorineural severe-to-profound hearing loss at 6 months of age and currently wears hearing aids in both ears. Her family chose an auditory/ oral communication approach. Olivia is receiving a cochlear implant evaluation from an interdisciplinary team—including a surgeon, an audiologist, an SLP, and ...
... sensorineural severe-to-profound hearing loss at 6 months of age and currently wears hearing aids in both ears. Her family chose an auditory/ oral communication approach. Olivia is receiving a cochlear implant evaluation from an interdisciplinary team—including a surgeon, an audiologist, an SLP, and ...
get to know your medical plan
... › Assistance in the activities of daily living, including, but not limited to, eating, bathing, dressing or other Custodial Services or self care activities, homemaker services and services primarily for rest, domiciliary or convalescent care. › Any services and supplies for or in connection with ...
... › Assistance in the activities of daily living, including, but not limited to, eating, bathing, dressing or other Custodial Services or self care activities, homemaker services and services primarily for rest, domiciliary or convalescent care. › Any services and supplies for or in connection with ...
Clinical Services Compliance Manual Office of Regulatory
... Element #1: Conducting internal monitoring and auditing through performance of periodic audits: An ongoing evaluation process is important to a successful compliance program. This ongoing evaluation includes not only whether the physician practice’s standards and procedures are in fact current and a ...
... Element #1: Conducting internal monitoring and auditing through performance of periodic audits: An ongoing evaluation process is important to a successful compliance program. This ongoing evaluation includes not only whether the physician practice’s standards and procedures are in fact current and a ...
FY17 Chart B: Self-Assessment in Relationship to the Maryland
... Occupational Safety and Health Administration (OSHA), pharmacy licensing, child abuse reporting, and other laws and regulations governing healthcare programs. Where applicable, all providers of service must be eligible for reimbursement for services rendered. A data collection system must be maintai ...
... Occupational Safety and Health Administration (OSHA), pharmacy licensing, child abuse reporting, and other laws and regulations governing healthcare programs. Where applicable, all providers of service must be eligible for reimbursement for services rendered. A data collection system must be maintai ...
Comparing Health Care Cost Containment Proposals Matrix
... Beneficiary Incentives and Cost-Sharing: Several proposals offer policy changes to influence beneficiary behavior. For example: To lower costs for Medicare beneficiaries and encourage more appropriate utilization of care, BPC suggests that beginning in 2016 all supplemental coverage from Medigap pl ...
... Beneficiary Incentives and Cost-Sharing: Several proposals offer policy changes to influence beneficiary behavior. For example: To lower costs for Medicare beneficiaries and encourage more appropriate utilization of care, BPC suggests that beginning in 2016 all supplemental coverage from Medigap pl ...
HOME HEALTH CARE
... the requirement to offer coverage for EHBs. However, if such plans choose to provide coverage for benefits which are deemed EHBs (such as maternity benefits), the ACA requires all dollar limits on those benefits to be removed on all Grandfathered and Non-Grandfathered plans. The determination of whi ...
... the requirement to offer coverage for EHBs. However, if such plans choose to provide coverage for benefits which are deemed EHBs (such as maternity benefits), the ACA requires all dollar limits on those benefits to be removed on all Grandfathered and Non-Grandfathered plans. The determination of whi ...
Executive Summary
... released. It outlines five Actions to stimulate “partnerships at all levels of society to engage in programs to promote oral health and prevent disease.” The Call to Action encourages inclusion of oral health promotion, disease prevention, and oral health care in all health policy agendas set at loc ...
... released. It outlines five Actions to stimulate “partnerships at all levels of society to engage in programs to promote oral health and prevent disease.” The Call to Action encourages inclusion of oral health promotion, disease prevention, and oral health care in all health policy agendas set at loc ...
The Impact of Managed Care Payer Contracts on the Subspecialty
... disenfranchised 9 and medically fragile groups, especially poor, developmentally disabled children. The private sector, thus far, is not committed to assuring competent, accessible health care to the uninsured 1" or lower income patient, the ethnic minority populations, and other ill communities who ...
... disenfranchised 9 and medically fragile groups, especially poor, developmentally disabled children. The private sector, thus far, is not committed to assuring competent, accessible health care to the uninsured 1" or lower income patient, the ethnic minority populations, and other ill communities who ...
practice guidelines for telemental health with children and adolescents
... diseases. Accordingly, it should be recognized that compliance with these guidelines will not guarantee accurate diagnoses or successful outcomes with respect to the treatment of individual patients, and ATA disclaims any responsibility for such outcomes. These guidelines are provided for informatio ...
... diseases. Accordingly, it should be recognized that compliance with these guidelines will not guarantee accurate diagnoses or successful outcomes with respect to the treatment of individual patients, and ATA disclaims any responsibility for such outcomes. These guidelines are provided for informatio ...
Using Care Management Entities for Behavioral Health Home Providers:
... manner. CMEs facilitate increased access and coordination with primary care and medical homes. Services and supports, which are guided by the strengths and needs of the enrollee, are developed through a wraparound planning process consistent with systems of care philosophy that results in an individ ...
... manner. CMEs facilitate increased access and coordination with primary care and medical homes. Services and supports, which are guided by the strengths and needs of the enrollee, are developed through a wraparound planning process consistent with systems of care philosophy that results in an individ ...
REV. JUNE 7, 2014 NEBRASKA DEPARTMENT OF MEDICAID SERVICES
... coverage criteria for the specific item. Documentation which substantiates that the client's condition meets the coverage criteria must be on file with the provider (see 471 NAC 7-007 for documentation of medical necessity requirements). Exception: Some items of equipment may be covered under certai ...
... coverage criteria for the specific item. Documentation which substantiates that the client's condition meets the coverage criteria must be on file with the provider (see 471 NAC 7-007 for documentation of medical necessity requirements). Exception: Some items of equipment may be covered under certai ...
Provider Manual - BayCare Health System
... precertification should be completed by the physician rendering or ordering the service and sent to CIGNA. Services requiring precertification that have not been authorized by CIGNA will not be covered. If the Member or the Member’s provider believes that they are in need of a service or physician ...
... precertification should be completed by the physician rendering or ordering the service and sent to CIGNA. Services requiring precertification that have not been authorized by CIGNA will not be covered. If the Member or the Member’s provider believes that they are in need of a service or physician ...
New Opportunities, New Approaches: Serving Children with Special Health Care Needs Under SCHIP Volume II: Case Study.
... separate state program called The Healthy Families Program. The Medi-Cal expansion raised the eligibility level for adolescents aged 14 to 18 to 100% of the Federal Poverty Level (FPL). In addition, the Healthy Families Program was created to cover children ages 1 through 18 with family incomes betw ...
... separate state program called The Healthy Families Program. The Medi-Cal expansion raised the eligibility level for adolescents aged 14 to 18 to 100% of the Federal Poverty Level (FPL). In addition, the Healthy Families Program was created to cover children ages 1 through 18 with family incomes betw ...
“The Tooth of the Matter: A Update on State Oral Health Dental
... Committee (LAC) member, will serve on the transition committee. The committee is tasked with developing a plan to accept $16 billion in federal funds to expand Medicaid in Louisiana. “Expanding access to health care for Louisiana’s working families is one of my top priorities,” said Governor-elect E ...
... Committee (LAC) member, will serve on the transition committee. The committee is tasked with developing a plan to accept $16 billion in federal funds to expand Medicaid in Louisiana. “Expanding access to health care for Louisiana’s working families is one of my top priorities,” said Governor-elect E ...
communicating samhsa`s role in health care reform and
... could fill, using data from the National Treatment Expenditure Studies and other routinely gathered data from SAMHSA research. Another interviewee broadened the scope of this point somewhat: “This is the logic model: substance abuse and mental health disorders are expensive, but we have tools that w ...
... could fill, using data from the National Treatment Expenditure Studies and other routinely gathered data from SAMHSA research. Another interviewee broadened the scope of this point somewhat: “This is the logic model: substance abuse and mental health disorders are expensive, but we have tools that w ...
10-17 - Dental Rules - The Oklahoma Health Care Authority
... Retarded (ICF/MR) and who have been approved for ICF/MR level of care, similar to the scope of services available to individuals under age 21. (C) Pregnant women are covered under a limited dental benefit plan (Refer to (a)(4) of this Section). (2) Home and community based waiver services (HCBWS) fo ...
... Retarded (ICF/MR) and who have been approved for ICF/MR level of care, similar to the scope of services available to individuals under age 21. (C) Pregnant women are covered under a limited dental benefit plan (Refer to (a)(4) of this Section). (2) Home and community based waiver services (HCBWS) fo ...
Benefit Summary PPO Plan
... this Benefit Summary conflicts in any way with the Certificate of Coverage (COC), Riders, and/or Amendments, those documents shall prevail. It is recommended that you review these documents for an exact description of the services and supplies that are covered, those which are excluded or limited, a ...
... this Benefit Summary conflicts in any way with the Certificate of Coverage (COC), Riders, and/or Amendments, those documents shall prevail. It is recommended that you review these documents for an exact description of the services and supplies that are covered, those which are excluded or limited, a ...
CA-188816 1 Group Medical Coverage Agreement Group Health
... has the right to designate any Network Personal Physician who participates in one of the Group Health networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal ...
... has the right to designate any Network Personal Physician who participates in one of the Group Health networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal ...
The Health Plan Schedule of Benefits
... prescription coverage, the Plan will process these drugs/supplies as medical benefits as outlined in this Schedule of Benefits. Please contact the Plan should you have any questions. Members with prescriptions coverage: prescriptions prescribed for biologically based mental illnesses will be covered ...
... prescription coverage, the Plan will process these drugs/supplies as medical benefits as outlined in this Schedule of Benefits. Please contact the Plan should you have any questions. Members with prescriptions coverage: prescriptions prescribed for biologically based mental illnesses will be covered ...
Procedure Code Review
... – NOTE: Referral for treatment of head lice is not claimable if it is not provided by a Medicaid provider, such as when a student is treated solely at home by parents. – Checking head lice as part of regular school policy or procedures for all students is not a claimable activity under MAC. In order ...
... – NOTE: Referral for treatment of head lice is not claimable if it is not provided by a Medicaid provider, such as when a student is treated solely at home by parents. – Checking head lice as part of regular school policy or procedures for all students is not a claimable activity under MAC. In order ...
Oral health perspectives of maternal women and their health care
... preventive and problem focused dental care by pregnant women are compared to non-pregnant women. Additionally, rates are frequently stratified by race, income status, educational attainment, and insurance status to gain additional information about disparities in maternal oral health. The most recen ...
... preventive and problem focused dental care by pregnant women are compared to non-pregnant women. Additionally, rates are frequently stratified by race, income status, educational attainment, and insurance status to gain additional information about disparities in maternal oral health. The most recen ...
BCBS Traditional Plus Dental Plan
... applicable Blue Cross Blue Shield of Michigan certificates and riders. Payment amounts are based on the Blue Cross Blue Shield of Michigan approved amount, less any applicable deductible and/or copay amounts required by your plan. This coverage is provided pursuant to a contract entered into in the ...
... applicable Blue Cross Blue Shield of Michigan certificates and riders. Payment amounts are based on the Blue Cross Blue Shield of Michigan approved amount, less any applicable deductible and/or copay amounts required by your plan. This coverage is provided pursuant to a contract entered into in the ...
The National Research Council/ Institute of Medicine`s Adolescent
... • Setting out-of-pocket cost sharing at levels that do not discourage use of services. • Reimbursing providers at market-based rates. • Incorporating performance measures for comprehensive services into criteria for credentialing, payfor-performance, and quality measurement. States can use regula ...
... • Setting out-of-pocket cost sharing at levels that do not discourage use of services. • Reimbursing providers at market-based rates. • Incorporating performance measures for comprehensive services into criteria for credentialing, payfor-performance, and quality measurement. States can use regula ...