Child Health Check-Up (formerly EPSDT) - Herman & Associates ...

Child Health Check-Up Coverage and Limitations HandbookProvider Responsibilities, continuedProviderResponsibilitiesA Child Health Check-Up provider is responsible for:• Providing or coordinating all the required components of the Child HealthCheck-Up and ensuring that the health screening is conducted in fullaccordance with program regulations;• Ensuring that initial and periodic health screenings are available to eligibleindividuals;• Retaining the required documentation of the health screening in the recipient'smedical record;• Making appropriate referrals and follow-up for further diagnosis and treatmentof those problems that the provider cannot treat;• Offering the recipient freedom of choice on direct referrals to providers forfurther diagnosis and treatment as described below; and• Reporting any evidence of neglect or suspected child abuse indicated by thedevelopmental history or health screening to the Abuse Registry at 800-342-9152. Providers must report all supporting evidence.Note: See the Florida Medicaid Provider General Handbook, for additionalprovider responsibilities and record keeping requirements.ReferralsIf the recipient is enrolled in MediPass, the MediPass primary care provider mustauthorize follow-up services.If the recipient is in an HMO, the referral will be to providers in the HMO network.Referrals to providers outside of the HMO network may occur when a medicallyindicated specialist is not available within the HMO network.October 2003 1-5