Get the free EPSDT Fact Sheet - Department of Medical Assistance Services - dhhr wv
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Screen Date___West Virginia Department of Health and Human Resources
Early and Periodic Screening, Diagnosis, and Treatment (EPS DT) Hatcheck Program Preventive Health Screen11, 12, 13 and 14 Year
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How to fill out epsdt fact sheet
How to fill out epsdt fact sheet
01
Obtain an EPSDT fact sheet form from your healthcare provider or healthcare facility.
02
Fill out the personal information section, including the child's name, date of birth, and contact information.
03
Provide information about the child's medical history, including any chronic conditions or medications they are currently taking.
04
Record the results of any physical exams or screenings that have been completed for the child.
05
Document any recommendations or follow-up care that has been prescribed by the healthcare provider.
06
Review the completed EPSDT fact sheet for accuracy and make any necessary corrections before submitting it to the healthcare provider.
Who needs epsdt fact sheet?
01
Children who are eligible for Medicaid benefits
02
Children who require regular medical check-ups and screenings
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What is epsdt fact sheet?
The EPSDT fact sheet is a document that provides information on the Early and Periodic Screening, Diagnostic, and Treatment program.
Who is required to file epsdt fact sheet?
Healthcare providers participating in the EPSDT program are required to file the EPSDT fact sheet.
How to fill out epsdt fact sheet?
To fill out the EPSDT fact sheet, healthcare providers should include information on screenings, diagnoses, treatments, and outcomes for eligible children.
What is the purpose of epsdt fact sheet?
The purpose of the EPSDT fact sheet is to track and improve the health and well-being of children enrolled in the EPSDT program.
What information must be reported on epsdt fact sheet?
Information such as screenings, diagnoses, treatments, and outcomes for eligible children must be reported on the EPSDT fact sheet.
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