NC DMA: Health Check Manual

Division of Medical Assistance
Providing access to high quality, medically necessary health care for eligible North Carolina residents through cost effective purchasing of health care services and products.

Medicaid for
North Carolinians

Health Choice for Children

Medicaid Providers

DMA
Publications

Health Check Program Policies and Procedures Manual for Health Check Coordinators

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EPSDT Policy Update

Table of Contents

Section	Content
A	History and Organization
B	Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program
C	Funding & Budgetary Guidance for Health Check Outreach Projects
D	Reimbursement for Health Check Coordination Services
E	Health Check Equipment, Furnishings and Supply Needs
F	Requirements for Health Check Coordinator Positions
G	Automated Information and Notification System
H	Documentation of Health Check Coordinator Activities
I	Submission of Required Documents
J	County Options Change Request Form
K	Project Record Files and Policies and Procedures
L	Technical Visits, Comprehensive Site Visits, Evaluation
M	Review of Projects for Continued Funding
N	Establishment of New Health Check Outreach Projects
O	Adding New HCC Positions in Existing Outreach Projects
P	Home Visits
Q	Standardized Letters

Appendix	Content
1	Health Check Program Overview
2	Health Check Contact List
3	Managed Care Consultants
4	Health Check Project Agreements - DMA Agreements; DPH Agreements; DMA Collaboration Agreements
5	Health Check Coordinator Job Description
6	Suggested Local Orientation Guide for New Health Check Coordinators
7	Health Check Outreach Project Annual Plan Form
8	Health Check Outreach Project Site Visit, Evaluation Form
9	Automated Information and Notification System Overview
10	County Options Change Request - Instructions; COCR Form
11	Monthly Accounting of Activities Report - Instructions ; MAAR Form
12	Health Check Implementation Plan
13	Funding & Budgetary Guidance for Health Check Outreach Projects
14	Letter of Intent
15	Abbreviations
16	Technical Visit Form
17	Standard Letters (English)
17	Standard Letters (Spanish)
17	Standard Letters (Hmong)
18	Dental Lawsuit Settlement Agreement
19	ER Letters (English)
19	ER Letters (Spanish)
20	HIPAA Memo to HCC's & Local Care Manager

Last updated September 24, 2008