| Q: |
Who do I contact with billing questions/concerns or other questions/concerns regarding the EPSDT program? |
| A: |
Please contact the Provider Relations EPSDT representative at (502) 585-7920 or (800) 578-0603 ext. 7920. |
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| Q: |
What are the timely filing requirements for EPSDT? |
| A: |
Practitioners must file within 180 days from the original date of service. This is consistent with the Plan’s policy for all claims. |
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| Q: |
Are practitioners allowed to file sick and EPSDT visits for the same date of service? |
| A: |
Yes, practitioners may file sick and EPSDT visits for the same date of service as long as the practitioner bills appropriately. The EPSDT Screening Form should be submitted for the EPSDT service, and the CMS 1500 should be submitted for the sick visit. |
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| Q: |
How can I verify if a member is eligible for EPSDT? |
| A: |
To verify eligibility, contact the EPSDT department at (800) 578-0603 ext. 8210 or (502) 585-8210. |
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| Q: |
I am having trouble determining the interval screenings for EPSDT. Is there a tool available to help with this? |
| A: |
Yes, please download the EPSDT Interval Screening Calculator at www.passporthealthplan.com.
(View the instructions for the "EPSDT Interval Screening Calculator.").
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| Q: |
How do I obtain our EPSDT screens and immunizations due list(s)? |
| A: |
Monthly EPSDT screens and immunizations due lists for Passport Health Plan members are sent to practitioner offices one month before they are due. If your office is currently not receiving a list, please contact the EPSDT representative at (502) 585-7920 or (800) 578-0603 ext. 7920. |
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| Q: |
How do I request outreach for noncompliant EPSDT members? |
| A: |
Passport Health Plan asks that prior to contacting the Plan for outreach, the practitioner office attempts outreach to the member three times (i.e. phone calls, letters, and/or postcards). |
If these efforts have failed, please contact the EPSDT representative at (800) 578-7943 ext. 7920 to schedule member outreach. Within 60 days from the outreach request, the practitioner will receive notification regarding the outcome of the home visit.