Early And Periodic Screening, Diagnostic, And Treatment

Healthy Blue is committed to ensuring members receive age-appropriate preventive health services. Based on our claims data, we can send PCPs a list of members who have not received well-child services according to our schedule. We also reach out to these members, encouraging them to contact their PCPs to set up appointments for needed services. If you are interested in obtaining this information to close these gaps in care, please contact your Provider Relations representative at 833-388-1406 Monday through Friday 7 a.m. to 8 p.m. CT.

The list is based on our claims data and only includes information from start of a member’s enrollment. In some cases, the appropriate services may have been provided after the date of the report. To ensure accuracy in tracking preventive service appointments, please submit a claim form.

Services must be rendered on or after the due date in accordance with federal and state EPSDT guidelines.

Vaccinations

The Advisory Committee on Immunization Practices (ACIP) recommends vaccine doses administered up to four days before the minimum interval or age be counted as valid. This is part of an effort to increase the flexibility of the Childhood Immunization Schedule. It does not change the recommendation for routine vaccination but makes an allowance that should be considered when evaluating records after a child has been vaccinated.

For More Information

Review your Provider Manual for more information on the EPSDT program or contact your Provider Relations representative.

Additional Resources