Informing Members About Healthchek. In addition to the Healthchek requirements specified in OAC rules 5160-26-03(H)(12) and 5160-26- 08.2(B)(4)(i), the MCP must: i. Inform each member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCP about the Healthchek program as prescribed by ODM and as specified by 42 C.F.R. Section 441.56. An MCP may meet this requirement by including information with the new member materials as specified in paragraph 24.d of this Appendix. In addition, the MCP must communicate with the member’s local County Department of Job and Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) benefit. The MCP’s member handbooks must be provided to members within the time frames specified in 24.d of this Appendix, and must include verbatim the model language developed by ODM. The model language at a minimum will include: a. A description of the types of screening and treatment services covered by Healthchek; b. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; c. Information that Healthchek services are provided at no additional cost to the member; and d. Information that providers may request prior authorization for coverage of services that have limitations and/or are not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information in 25.a.ii on the MCP's member website specified in 41.b. of this Appendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to its members at the following intervals: a. When the member is 9 months old; b. When the member is 18 months old; c. When the member is 30 months old; d. January of each calendar year to all members under the age of 21; and e. At the beginning of each school year in the month of July for members from age 4 to under 21. The mailing templates provided by ODM will not exceed two (2) 8x11 pages for each mailing with most mailings being one (1) page or less in length. The MCP must populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service and age of member on the date of service).
Appears in 2 contracts
Samples: Provider Agreement, Provider Agreement
Informing Members About Healthchek. In addition to the Healthchek requirements specified in OAC rules 5160-26-03(H)(12) and 5160-26- 08.2(B)(4)(i), the MCP must:
i. Inform each member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCP about the Healthchek HealthChek program as prescribed by ODM and as specified by 42 C.F.R. Section 441.56. An MCP may meet this requirement by including information with the new member materials as specified in paragraph 24.d of this Appendix. In addition, the MCP must communicate with the member’s local County Department of Job and Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services).
ii. Provide members with accurate information in the member handbook regarding Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) benefit. The MCP’s member handbooks must be provided to members within the time frames specified in 24.d of this Appendix, and must include verbatim the model language developed by ODM. The model language at a minimum will include:
a. A description of the types of screening and treatment services covered by Healthchek;
b. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics;
c. Information that Healthchek services are provided at no additional cost to the member; and
d. Information that providers may request prior authorization for coverage of services that have limitations and/or are not covered for members age 21 and older if the services are medically necessary EPSDT services.
iii. Provide the above Healthchek information in 25.a.ii on the MCP's member website specified in 41.b. of this Appendix.
iv. Deliver Healthchek information as provided, or as approved, by ODM to its members at the following intervals:
a. When the member is 9 months old;
b. When the member is 18 months old;
c. When the member is 30 months old;
d. January of each calendar year to all members under the age of 21; and
e. At the beginning of each school year in the month of July for members from age 4 to under 21. The mailing templates provided by ODM will not exceed two (2) 8x11 pages for each mailing with most mailings being one (1) page or less in length. The MCP must populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service and age of member on the date of service).
Appears in 2 contracts
Samples: Provider Agreement, Provider Agreement
Informing Members About Healthchek. In addition to the Healthchek requirements specified in OAC rules 5160-26-03(H)(1203(H) and 5160-26- 26-08.2(B)(4)(i), the MCP must:
i. Inform each member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCP about the Healthchek program as prescribed by ODM and as specified by 42 C.F.R. Section 441.56. An MCP may meet this requirement by including information with the new member materials as specified in paragraph 24.d of this Appendix. In addition, the MCP must may be required to communicate with the member’s local County Department of Job and Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services).
ii. Provide members with accurate information in the member handbook regarding Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) benefit. The MCP’s member handbooks must be provided to members within the time frames specified in 24.d of this Appendix, and must include verbatim the model language developed by ODM. The model language at a minimum will include:
a. A description of the types of screening and treatment services covered by Healthchek;
b. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics;
c. Information that Healthchek services are provided at no additional cost to the member; and
d. Information that providers may request prior authorization for coverage of services that have limitations and/or are not covered for members age 21 and older if the services are medically necessary EPSDT services.
iii. Provide the above Healthchek information in 25.a.ii on the MCP's member website specified in 41.b. of this Appendix.
iv. Deliver Healthchek information as provided, or as approved, by ODM to its members at the following intervals:
a. When the member is 9 months old;
b. When the member is 18 months old;
c. When the member is 30 months old;
d. January of each calendar year to all members under the age of 21; and
e. At the beginning of each school year in the month of July for members from age 4 to under 21. The .
v. Use the mailing templates provided by ODM that will not exceed two (2) 8x11 pages for each mailing with most mailings being one (1) page or less in length. The MCP must populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service and age of member on the date of service).two
Appears in 2 contracts
Samples: Provider Agreement, Provider Agreement
Informing Members About Healthchek. In addition to the Healthchek requirements specified in OAC rules 5160-26-03(H)(1203(H) and 5160-26- 26-08.2(B)(4)(i), the MCP must:
i. Inform each member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCP about the Healthchek program as prescribed by ODM and as specified by 42 C.F.R. Section 441.56. An MCP may meet this requirement by including information with the new member materials as specified in paragraph 24.d of this Appendix. In addition, the MCP must communicate with the member’s local County Department of Job and Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services).
ii. Provide members with accurate information in the member handbook regarding Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) benefit. The MCP’s member handbooks must be provided to members within the time frames specified in 24.d of this Appendix, and must include verbatim the model language developed by ODM. The model language at a minimum will include:
a. A description of the types of screening and treatment services covered by Healthchek;
b. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics;
c. Information that Healthchek services are provided at no additional cost to the member; and
d. Information that providers may request prior authorization for coverage of services that have limitations and/or are not covered for members age 21 and older if the services are medically necessary EPSDT services.
iii. Provide the above Healthchek information in 25.a.ii on the MCP's member website specified in 41.b. of this Appendix.
iv. Deliver Healthchek information as provided, or as approved, by ODM to its members at the following intervals:
a. When the member is 9 months old;
b. When the member is 18 months old;
c. When the member is 30 months old;
d. January of each calendar year to all members under the age of 21; and
e. At the beginning of each school year in the month of July for members from age 4 to under 21. The mailing templates provided by ODM will not exceed two (2) 8x11 pages for each mailing with most mailings being one (1) page or less in length. The MCP must populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service and age of member on the date of service).
Appears in 1 contract
Samples: Provider Agreement
Informing Members About Healthchek. In addition to the Healthchek requirements specified in OAC rules 5160-26-03(H)(1203(H) and 5160-26- 26-08.2(B)(4)(i), the MCP must:
i. Inform each member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCP about the Healthchek program as prescribed by ODM and as specified by 42 C.F.R. Section 441.56. An MCP may meet this requirement by including information with the new member materials as specified in paragraph 24.d of this Appendix. In addition, the MCP must communicate with the member’s local County Department of Job and Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services).
ii. Provide members with accurate information in the member handbook regarding Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) benefit. The MCP’s member handbooks must be provided to members within the time frames specified in 24.d of this Appendix, and must include verbatim the model language developed by ODM. The model language at a minimum will include:
a. A description of the types of screening and treatment services covered by Healthchek;
b. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics;
c. Information that Healthchek services are provided at no additional cost to the member; and
d. Information that providers may request prior authorization for coverage of services that have limitations and/or are not covered for members age 21 and older if the services are medically necessary EPSDT services.
iii. Provide the above Healthchek information in 25.a.ii on the MCP's member website specified in 41.b. of this Appendix.
iv. Deliver Healthchek information as provided, or as approved, by ODM to its members at the following intervals:
a. When the member is 9 months old;
b. When the member is 18 months old;
c. When the member is 30 months old;
d. January of each calendar year to all members under the age of 21; and
e. At the beginning of each school year in the month of July for members from age 4 to under 21. The mailing templates provided by ODM will not exceed two (2) 8x11 pages for each mailing with most mailings being one (1) page or less in length. The MCP must populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service and age of member on the date of service).
Appears in 1 contract
Samples: Provider Agreement
