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

Child Health Check-Up Coverage and Limitations HandbookHandbook Use and FormatPurposeThe purpose of the Medicaid handbooks is to furnish the Medicaid provider withthe policies and procedures needed to receive reimbursement for coveredservices provided to eligible Florida Medicaid recipients.The handbooks provide descriptions and instructions on how and when tocomplete forms, letters or other documentation.“Provider”The term “provider” is used to describe any entity, facility, person or group whois enrolled in the Medicaid program and renders services to Medicaid recipientsand bills Medicaid for services.“Recipient”The term “recipient” is used to describe an individual who is eligible forMedicaid.Coverage andLimitationsHandbookEach service handbook is named for the service it describes and is referred toas a "Coverage and Limitations Handbook." A provider who furnishes more thanone type of service will have more than one coverage and limitations handbook.ReimbursementHandbookEach reimbursement handbook is named for the claim form that it describes. Aprovider that bills on more than one type of claim form will have more than onereimbursement handbook.General HandbookGeneral information regarding the Florida Medicaid Program, recipient eligibility,provider enrollment, fraud and abuse policy and important resources forproviders are included in the Florida Medicaid Provider General Handbook. Thisgeneral handbook is distributed to all enrolled Medicaid providers and is updatedas needed.Chapter NumberingSystemThe first page of each chapter designates the chapter number. The chapternumber will appear as the first number of the page number at the bottom of eachpage in the handbook.Page NumberingPages are numbered consecutively by chapter. Page numbers follow thechapter number found at the bottom of each page.ii October 2003