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AmeriChoiceAMERIGROUPHealth Horizon NJ HealthUHPother___(08/04)New Jersey: Early and Periodic Screening, Diagnosis and Treatment Exam DATE:ADOLESCENCE: 17 YEARS Child's Name:Date of Birth:Allergies:Current
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How to fill out early and periodic screening
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Obtain the necessary forms and documents for the early and periodic screening.
02
Fill out the applicant's personal information accurately.
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Provide details about the applicant's medical history and any previous screenings.
04
Include information about any current medications or allergies the applicant may have.
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Submit the completed form to the appropriate healthcare provider for review.
Who needs early and periodic screening?
01
Children and adolescents who are eligible for Medicaid are in need of early and periodic screening to ensure they receive necessary healthcare services and screenings to monitor their physical and mental health.
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What is early and periodic screening?
Early and periodic screening refers to a set of preventive health services provided to children to identify health issues early on. This includes regular check-ups, developmental screenings, and immunizations.
Who is required to file early and periodic screening?
States are required to file early and periodic screening reports as part of the Medicaid program for eligible children and youth.
How to fill out early and periodic screening?
Early and periodic screening forms should be completed by healthcare providers during scheduled check-ups, detailing the services provided and any identified needs or referrals.
What is the purpose of early and periodic screening?
The purpose of early and periodic screening is to promote early detection and treatment of potential health issues in children, ensuring better health outcomes.
What information must be reported on early and periodic screening?
Information that must be reported includes the child's health status, services received, referrals made, and any identified health issues.
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