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EPS DT HEALTH SERVICES FOR CHILDREN WITH DISABILITIES Chapter Twenty of the Medicaid Services ManualIssued September 30, 2012State of Louisiana Bureau of Health Services FinancingLOUISIANA MEDICAID
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How to fill out epsdt health services for

01
To fill out EPSDT health services form, follow these steps:
02
Start by gathering all necessary information about the child, such as their name, date of birth, and contact information.
03
Make sure you have the child's Medicaid ID number and any other relevant insurance information.
04
Determine the type of EPSDT health service needed by the child, such as physical therapy, dental check-up, or vision screening.
05
Contact the child's primary care provider or pediatrician to discuss the specific EPSDT health services required.
06
Schedule an appointment with the healthcare provider to assess the child's health needs and determine the appropriate services.
07
Attend the appointment with the child and provide any requested documentation or medical records.
08
Discuss with the healthcare provider the child's medical history, any current health concerns, and any medications or treatments the child is currently undergoing.
09
Follow the healthcare provider's recommendations and complete any necessary forms or paperwork during the appointment.
10
Double-check all information provided on the EPSDT health services form for accuracy and completeness.
11
Submit the filled-out form to the appropriate entity, such as the child's Medicaid office or healthcare insurance provider.
12
Keep a copy of the filled-out form and any supporting documents for your records.
13
Follow up with the healthcare provider or Medicaid office to ensure that the EPSDT health services are authorized and scheduled for the child.

Who needs epsdt health services for?

01
EPSDT health services are designed for children and youth who are eligible for Medicaid coverage. This includes:
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- Infants, toddlers, children, and teenagers up to the age of 21.
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- Children with special healthcare needs or disabilities.
04
- Children from low-income families who meet the income and eligibility requirements for Medicaid.
05
EPSDT health services aim to provide comprehensive and preventive healthcare services to children to ensure their optimal growth, development, and well-being.
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EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) health services are designed to ensure that children and adolescents receive necessary preventive and comprehensive healthcare services.
Healthcare providers, including physicians, must file EPSDT health services for eligible children and adolescents.
EPSDT health services are typically filled out by healthcare providers during regular check-ups and screenings for children and adolescents.
The purpose of EPSDT health services is to promote early detection and intervention for potential health issues in children and adolescents.
EPSDT health services require reporting of medical history, physical exam results, developmental assessments, immunizations, and referrals for necessary treatments and follow-up care.
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