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

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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
Child Health Check-Up Coverage and Limitations HandbookHandbook Use and Format, continuedWhite SpaceThe "white space" throughout a handbook is characteristic of the handbookformat style. It enhances readability and allows space for writing notes duringtraining and for on-the-job reference.Characteristics of the HandbookFormatThe format used in this handbook represents a concise and consistent way ofdisplaying complex, technical material.Information BlockOne of the major features of the format is the information block, which replacesthe traditional paragraph. Blocks are separated by horizontal lines.The block consists of one or more paragraphs or diagrams about a portion of asubject. Each block is identified or named with a label.LabelLabels or names are located in the left margin of each information block. Theydescribe the content or function of the block.Labels provide key subject matter identification which facilitates scanning andlocating information quickly within a chapter or section within a chapter.NoteNote: is used most frequently to refer the user to material located elsewhere ina handbook that is pertinent to the subject being addressed within theinformation block.Note: also refers the user to other documents or policies contained in otherhandbooks.Topic RosterEach chapter contains a topic roster which lists the major subject areascovered in the chapter and gives the page number where the subject can befound. This topic roster serves as a table of contents for major sections withineach chapter.Handbook UpdatesHow Changes AreUpdatedThe Medicaid handbooks will be updated as needed. Lengthy changes ormultiple changes that occur at the same time will be sent on replacementpages.Brief changes will be sent as pen and ink updates. The pen and ink updateswill be incorporated on replacement pages the next time replacement pages areproduced.October 2003iii
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Jeb BushGovernorRhonda M. Medows, M
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Child Health Check-Up (formerly EPSDT) - Herman & Associates ...

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