HealthCheck Sample Clauses

HealthCheck i. Policies on the use of emergency and urgent care facilities.

HealthCheck. HealthCheck, a federally mandated benefit, is key to ensuring that children receive the preventive and follow up care they need, including appropriate dental, mental health, developmental, and specialty care. To the maximum extent possible, the PIHP must make every effort to ensure that HealthCheck exams are provided by primary care providers who understand the concept of trauma- informed care and who provide services based on this understanding and approach.

HealthCheck. HealthCheck is a preventive health checkup program for members under the age of 21. The HealthCheck program covers complete health checkups. These checkups are very important for children’s health. Your child may look and feel well, yet may have a health problem. Your doctor wants to see your children for regular checkups, not just when they are sick. The HealthCheck health program has three purposes:

HealthCheck. HealthCheck is Wisconsin’s name for the federally mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit for children under age 21. The EPSDT benefit is defined in federal law at §1905(r) of the Social Security Act and provides comprehensive and preventive health care services for all children under 21 years old. Federal and state regulations establish certain requirements for comprehensive HealthCheck screenings.

HealthCheck. The section below describes the HealthCheck requirements and responsibilities for MY2016. For MY2017 and beyond, the DHS will explore replacing the current HealthCheck measures with Bright Futures measures. Operational details for this modification will be discussed in the MY2017 HMO P4P Guide.

HealthCheck. Provide services as a continuing care provider as defined in Article I, and according to policies and procedures in Part D of the Wisconsin Medicaid Provider Handbook related to covered services. Provide HealthCheck screens at a rate equal to or greater than 80 percent of the expected number of screens. The rate of HealthCheck screens will be determined by the calculation in the HealthCheck Worksheet in Addendum XI. The Department will complete the worksheet from data provided by the HMO- from the HMO Utilization Report for calendar year 2000 and, for calendar year 2001, from HealthCheck screens the Department retrieves and identifies from the 2001 encounter data set. The HMO may complete the worksheet on its own, periodically, as a means to monitor its HealthCheck screening performance. HMO Contract for January 1, 2000 - December 31, 2001 For the 2000 HealthCheck worksheet data calculation, the number of HealthCheck screens reported on the 2000 HMO utilization Report must be substantiated by the number reported on the 2000 encounter data set. If for the year 2000, the encounter data set does not substantiate the HealthCheck screens reported on the HMO Utilization Report within 5 percent, the Department will require HMOs to submit a 2001 HMO Utilization Report. When the Department completes the HealthCheck worksheet using encounter data for calendar year 2001, the Department will identify and retrieve HealthCheck screening data from the encounter data set as of July 1, 2002. For those HMOs required to submit a 2001 HMO Utilization Report, the Department will compare the HealthCheck data submitted on the 2001 HMO Utilization Report with HealthCheck data reported on the encounter data set, and utilize the smaller number when completing the worksheet. If the HMO provides fewer screens in the contract year than 80 percent, the Department will recoup the funds provided to the HMO for the provision of the remaining screens. This formula will be used: