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Behavioral Health Network (BNET)
Behavioral Health Network (BNET)

... 13. Consumer: Person who receives substance abuse and/or mental health services. Consumer, patient, and consumer are used interchangeably. 14. Clinical Assessment: The collection of detailed information concerning an individual’s behavioral health, emotional and physical health, social roles, and ot ...
PENNSYLVANIA DENTAL JOURNAL
PENNSYLVANIA DENTAL JOURNAL

... of a budget stalemate had little to no impact on dentists, patients and oral health programs. Medical Assistance providers should receive reimbursements on a timely basis (an exception may be for those providers paid with grant money administered by the state). The Department of Health should still ...
Vieques, Puerto Rico
Vieques, Puerto Rico

... Insurance coverage is not the principal barrier to care for Viequenses. Instead, the fundamental challenge is absence of a cohesive long-term public health policy that addresses the elimination of all barriers to comprehensive primary care and treatment and the environmental factors in disease. Like ...
Billing Guidelines for Cleft Lip and Cleft Palate
Billing Guidelines for Cleft Lip and Cleft Palate

... they must pay) for any dental treatment for eligible members rendered under this mandate. For example, while members usually do not have a copayment for dental visits, when a visit occurs under the member’s medical benefit, you must collect the member’s cost-sharing (if applicable) to receive your w ...
Treating Children with Autism Spectrum Disorders
Treating Children with Autism Spectrum Disorders

... Children with ASD or other developmental disabilities often have difficulty with sensory stimuli, communicating their wants and needs, understanding expectations, feeling anxious, and behaving appropriately and cooperatively. For the parent of a child with an ASD, there can be much to have concerns ...
2011-12 Lexington Service AreA Certificate of Coverage
2011-12 Lexington Service AreA Certificate of Coverage

... This is a Certificate of Coverage but is not a legal document. The coverage of a Member can be terminated for non-payment of Premium, fraud or misrepresentation, intentional and abusive non-compliance with Plan provisions, Service Area limitations, uniform discontinuance of a type of coverage, or if ...
Assessment of oral health-related quality of life in Nigerian children
Assessment of oral health-related quality of life in Nigerian children

... malocclusion according to the DAI did not have worse OHRQoL than their counterparts who had minimal traits of malocclusion. Agou et al. [2008] in a study among Canadian children also could not conclusively state that increased malocclusion severity produced a direct increase in CPQ11-14 scores. This ...
CS150 Dental Plan Florida
CS150 Dental Plan Florida

... of the limiting age and subsequently as may be required by Company, but not more frequently than annually after the two-year period following the Dependent’s attainment of the limiting age. B. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that certain employers maintain ...
Dental Benefits-At-A-Glance - Northern Michigan University
Dental Benefits-At-A-Glance - Northern Michigan University

... With Blue Dental PPO Plus, members can choose any licensed dentist anywhere. However, they'll save the most money when they choose a dentist who is a member of the Blue Dental PPO network.1 Blue Dental PPO network- Blue Dental members have unmatched access to PPO dentists through the Blue Dental PPO ...
Community Oral Health Service Facility Guideline
Community Oral Health Service Facility Guideline

... providers, or investing in the community-based facilities of other primary health care providers (eg, primary health organisations or Māori oral health providers). Publicly funded dental facilities operated in conjunction with a DHB-funded contract would be expected to conform to the standards outli ...
Oral health-related quality of life of preschool children assisted at a
Oral health-related quality of life of preschool children assisted at a

... measures complement clinical indicators and provide a better understanding of health of individuals and the community1, having important implications for clinical dental practice and dental research2. Specific instruments that consider the child’s cognitive, social, and emotional stage have been dev ...
Return on Investment in Systems of Care
Return on Investment in Systems of Care

... and mental health disorders are the most expensive conditions in childhood. Children and youth who receive mental health and substance use services in Medicaid, while less than 10% of the overall Medicaid child population, account for an estimated 38% of all Medicaid child expenditures (Pires, Grime ...
A STATE POLICY AGENDA TO ELIMINATE RACIAL AND ETHNIC HEALTH DISPARITIES
A STATE POLICY AGENDA TO ELIMINATE RACIAL AND ETHNIC HEALTH DISPARITIES

... home- and community-based services and by assisting income eligible seniors to qualify for full Medicaid or Medicaid-financed coverage of Medicare cost sharing. New Jersey’s Senior Gold Program is an example of the prescription drug assistance programs created by some states to aid seniors who are i ...
Medicaid and Hospice Issue Brief - National Hospice and Palliative
Medicaid and Hospice Issue Brief - National Hospice and Palliative

... Elimination of the Medicaid hospice benefit would lead to greater use of acute care services (i.e. hospital admissions, emergency room visits, nursing home admissions, medications, etc.) at the end of life. Medicaid patients who once relied on hospice will seek care in an emergency department or hos ...
Healthy Smile, Healthy Child
Healthy Smile, Healthy Child

... years of age.1 The Guide aims to reduce oral health inequality by offering Well Child service providers information and understanding to provide early anticipatory guidance about the prevention of Early Childhood Caries (ECC). The Guide will enable Well Child services to raise awareness, educate and ...
Scope of Practice - Manitoba Dental Association
Scope of Practice - Manitoba Dental Association

... This document is to provide the licensed dentists of Manitoba with approve delegated procedures for registered dental assistants and dental therapists in a private office setting as recognized by the Manitoba Dental Association. An attachment to this document is provided as it relates of the scope o ...
2016 Guide to Canadian Benefits
2016 Guide to Canadian Benefits

... independent. We take the time to understand our clients and we take the concept of service very seriously. We achieve this by truly caring about all of our clients and putting their needs at the heart of everything we do. We believe it is this approach that sets us apart from our competitors and it ...
Plan 2200
Plan 2200

... Not Acceptable Services. Any service or supply which we determine not to be an acceptable service, as specified in the Evidence of Coverage (EOC). Cosmetic Services. Dental services necessary solely for cosmetic reasons including, but not limited to, bleaching of non-vital discolored teeth, veneers ...
Aetna MedicareSM Plan (PPO) 1 2017 Medical Benefits Chart
Aetna MedicareSM Plan (PPO) 1 2017 Medical Benefits Chart

... Some members may also receive extra support from a case manager. ...
HealthChoice HDHP
HealthChoice HDHP

... The Certificate of Coverage, any amendments or attached papers, and your individual application make up your Contract and your complete coverage with Anthem for health care Benefits. This Certificate of Coverage replaces any previous Certificates of Coverage you may have received. Services provided ...
The Status of Oral Health in Minnesota
The Status of Oral Health in Minnesota

... benefits for older adults in the state, it is less likely that this population will seek oral health care and will eventually compromise their quality of life and health. According to Centers for Medicaid and Medicare Services (CMS), in 2009, the national dental services expenditure was $102.2 billi ...
Salaried Primary Dental Care Services
Salaried Primary Dental Care Services

... their area. This requirement extends to those sectors of the population who may be unable to access general dental services, and SPDCS have traditionally had an important role in enabling them to meet this obligation. However as directly provided services, SPDCS have not received the same level of a ...
Your Guide to Dental and Vision Benefits Group Benefit Plan
Your Guide to Dental and Vision Benefits Group Benefit Plan

... periodontal treatment (per quadrant). Predetermination of Benefits A process by which the treating dentist may submit their treatment plan and supporting documentation prior to any proposed treatment that is expected to exceed a specific dollar amount. The administrator will review the information s ...
General Anesthesia and Conscious Sedation Services
General Anesthesia and Conscious Sedation Services

... This Dental Coverage Guideline provides assistance in interpreting UnitedHealthcare dental benefit plans. When deciding coverage, the member specific benefit plan document must be referenced. The terms of the member specific benefit plan document [e.g., Certificate of Coverage (COC), Schedule of Ben ...
Plan 2100
Plan 2100

... Not Acceptable Services. Any service or supply which we determine not to be an acceptable service, as specified in the Evidence of Coverage (EOC). Cosmetic Services. Dental services necessary solely for cosmetic reasons including, but not limited to, bleaching of non-vital discolored teeth, veneers ...
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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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