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National Interest Waiver

Details: For more information regarding NIWs, please contact: Sadé Diggs. Maryland Department of Health. 201 W. Preston Street. Baltimore, MD 21201. Phone: 410-767- 71 41. [email protected] . Cheryl De Pinto. Maryland Department of Health.

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Population Health Improvement Plan for the State of Maryland

Details: health, social services and particularly the primary care arenas. These efforts will require providers/payers to address social determinants of health, promote community-based care and utilize the highest value setting. Finally, success will require intense focus on particular community health …

› Verified 7 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Transformation/Population%20Health%20Improvement%20Plan.pdf Go Now

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Maryland Public Behavioral Health System (PBHS) Level of

Details: Qualified Health Center or licensed in accordance with COMAR 10.63 as a substance use, mental health or integrated behavioral health program at the following levels of care: - Ambulatory SUD programs for Level 1 and Level 2.1 - Residential SUD programs for Level 3.1, 3.3, and 3.5 - Outpatient Mental Health …

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› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20IV/OPTUM%20Level%20of%20Care%20LOC%20-%20Appendix.pdf Go Now

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Maryland PBHS Provider Manual

Details: Health Services and BHA oversee and have the authority over the PBHS, which includes policy development, statewide planning, resource allocation, and continuous quality improvement strategies. Effective January 1, 2020, Optum is the Administrative Service Organization (ASO)

› Verified 6 days ago

› Url: https://pophealth.health.maryland.gov/Community-Health-Workers/Documents/OPTUM%20PBHS%20Provider%20Manual%20January%202020.PDF Go Now

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Medical Decision Making for Outpatient E/M Codes

Details: determinants of health (SDoH) [e.g., socioeconomic status, geographic location, education, employment, transportation access) 99214 30-39. Level 5 High Extensive (Must meet the requirements of at least 2 out of 3 categories) High risk 99205 60-74 High • 1 or more chronic illnesses

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Maryland Community Health Worker Core Competencies

Details: advisor, health coach, community health coach, lay health advocate, family advocate, community health care worker, health educator, liaison, promoter, outreach worker, promotores de salud, peer counselor, health interpreter, public health aide, and more. Community Health Worker core competencies identify abilities and skills that a CHW is expected

› Verified 7 days ago

› Url: https://pophealth.health.maryland.gov/Community-Health-Workers/Documents/Maryland-CHW-Core-Competencies.pdf Go Now

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Community Health Worker (CHW) Certification Application

Details: health advisor, health coach, community health coach, lay health advocate, family advocate, community health care worker, health educator, liaison, promoter, outreach worker, promotores de salud, peer counselor, health interpreter, public health aide, and more. This Letter of Validation is one component of a CHW Certification Application.

› Verified 7 days ago

› Url: https://pophealth.health.maryland.gov/Community-Health-Workers/Documents/Grandparenting-Letter-of-Validation-Form.pdf Go Now

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MDH Health Department Billing Manual & COVID-19

Details: HEALTH CARE DIVISION EDLANDER, LLC HEALTH CARE DIVISION 10 Clinicians may base the E/M service level on: Medical Decision Making(MDM) Only. OR Time: o Time is defined as “all of the time” associated with the E/M on the day of the encounter. o Concept of time is aligned with E/M criteria changes effective January 1, 2021.

› Verified 2 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/Webinar%20-%20MDH%20Manual%20and%20COVID-19%204-22-2020%20FINAL.pdf Go Now

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Code and Guideline Changes

Details: other qualified health care professional’s time is spent in the supervision of clinical staff who perform the face-to-face services of the encounter, use 99211. A shared or split visit is defined as a visit in which a physician and other qualified healthcare professional(s)

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› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Front%20Matter/AMA%20E%20and%20M%202021%20Coding%20Changes.pdf Go Now

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Billing Maryland Medicaid: Guidance for SBHCs

Details: •Federally Qualified Health Center •Expand access to medically underserved areas/populations •Primary care, preventative care, oral health, mental health and SUD treatment services •FQHC-specific rates •T1015: all-inclusive code . 17

› Verified 4 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20IV/SBHC%20Introduction%20to%20Billing%20and%20Coding.pdf Go Now

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Baltimore County Department of Health

Details: demographics, health and healthcare resources, behavioral health surveys, county rankings, and disease trends. The data collection process began in July 2014 and the

› Verified 4 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Resources/Baltimore%20County_CHNA_20142015.pdf Go Now

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MARYLAND MINOR CONSENT LAWS Who Can Consent For …

Details: the judgment of the attending physician, the life or health of the minor would be affected adversely by delaying treatment to obtain the consent of another individual [Md. Code Ann., Health-Gen. II § 20-102(b)] The health care provider shall inform the minor’s parent or guardian. The health care provider may treat a patient who is incapable

› Verified 8 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20VII/MD%20Minor%20Consent%20Laws%2010%2026%2012.pdf Go Now

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Understanding Features & Functions of an EHR

Details: Health record output - Allow users to define the records and/or reports that are considered the formal health record for disclosure purposes, and provide a mechanism for both chronological and specified record element output. Specialized views - Present specialized views based on the encounter-specific values, clinical protocols and business rules.

› Verified 6 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20V/EHR%20Functions%20and%20Features.pdf Go Now

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CHARLES COUNTY HEALTH NEEDS ASSESSMENT

Details: The biggest health problems that surfaced from the online survey included: obesity, drug use, tobacco use, affordable housing, and alcohol use. Long Survey: Top 10 Most Serious Health Problems in Charles County The protective health behaviors that Charles County residents were displaying included: always

› Verified 9 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Resources/Charles_CHNA_2015.pdf Go Now

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USFHPUS Family Health Plan Johns Hopkins 2020 2011-2012

Details: comprehensive TRICARE Prime health care benefits to members of the uniformed services and is modeled after a health maintenance program similar to a Health Maintenance Organization (HMO). TRICARE Prime, the DoD sponsored military managed health care program, provides enhanced

› Verified 8 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20VI/JH%20Family%20HealthPlan%20Prov%20Manual%20May%202020.pdf Go Now

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LIST OF MEDICARE TELEHEALTH SERVICES Code Short …

Details: 96161 Caregiver health risk assmt Yes 96164 Hlth bhv ivntj grp 1st 30 Yes 96165 Hlth bhv ivntj grp ea addl Yes 96167 Hlth bhv ivntj fam 1st 30 Yes 96168 Hlth bhv ivntj fam ea addl Yes 96168 Hlth bhv ivntj fam ea addl Yes 96170 Hlth bhv ivntj fam wo pt 1st Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 Non-covered service

› Verified 1 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Front%20Matter/COVID-19/Telehealth%20Services%20for%20PHE%20for%20the%20COVID-19%20pandemic%20effec.pdf Go Now

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Version 27 April 2021 2020 April

Details: Senate Bill 104 – Health Officer’s Authority to Retain Collections and Waive Charges COMAR 10.02.01.07 – Ability to Pay and Fees to be Collected LHD – Essential Community Provider January 31, 2016 MD HealthBenefit Exchange

› Verified 2 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/LHD%20Billing%20Manual%20V27/Manual%20Table%20of%20Contents%20V27%20April%20%202021.pdf Go Now

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Public Mental Health System Rates Effective July 1, 2018

Details: S0201 Mental health partial hosp, tx <24 hours 223.72 S0201-52 Intensive outpatient program (IOP) 121.76 S9480 Intensive OP psych svcs, per diem (clinic model) 142.45 S9480 C&A Intensive OP psych svcs, per diem (clinic model) 169.34 H0032 Interdisciplinary team tx plng w/patient present 91.02 H0046 Therapeutic Nursery 46.35 OCCUPATIONAL THERAPY

› Verified 3 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20IV/FY19%20PMHS%20Fee%20Schedule.pdf Go Now

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Community Health Needs Assessment

Details: Health Department, Union Hospital, and especially among behavioral health providers, as there is a substantive correlation between the use of illicit substances and poor mental health status. In Cecil County there has also been a steady increase in the amount of drug overdose or drug

› Verified 7 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Resources/Cecil_CHNA_2016.pdf Go Now

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Community Health Assessment

Details: importance of core public health services to the community. This document is a combination of information from the BCHD Healthy Baltimore 2020, Community Health Survey, and Neighborhood Health Profile reports, local hospital Community Health …

› Verified 7 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Resources/Baltimore%20City_CHA_2017.pdf Go Now

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A Public Health Needs Assessment

Details: Access to care for behavioral health conditions is a critical public health need in Maryland. Trends in the rate of emergency department visits for mental health related conditions increased from 2,792/100,000 in 2010 to 3,379/100,000 in 2013.

› Verified 6 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Maryland%20Public%20Health%20Needs%20Assessment%202014.pdf Go Now

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Maryland Department of Health Conrad 30 (J-1 Visa Waiver

Details: Health Professional Shortage Area (HPSA); sign a contractto begin employment at such a facility within 90 days of receiving such Waiver; work at the health care facility within 90 days of receiving such a Waiver; continue to work at the health care facility for a total of 40 hours per week, and not less than three years; may obtain a waiver.

› Verified 9 days ago

› Url: https://pophealth.health.maryland.gov/Documents/J1%20Visa%20Waiver/Maryland%20J-1%20Policy%20and%20Procedures%20-%209-15-2020.pdf Go Now

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PROVIDER ALERT Updates to Medical Necessity Criteria for

Details: Mental Health- Intensive Outpatient Program (IOP) Mental Health- Partial Hospitalization Program (PHP) Respite Therapeutic Behavioral Services (TBS) Residential Substance Use Disorder Treatment Level 3.3 or higher Substance Use Disorder-Intensive Outpatient Program (IOP)

› Verified 3 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/LHD%20Billing%20Manual%20V27/OPTUM%20Psych%20Medical%20NecessityAlert%20_%2003012021.pdf Go Now

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State Community Health Worker Advisory Committee Meeting

Details: community health workers in COMAR 10.68.02.03 may be suspended under the conditions listed in the appendix to this Notice and replaced with supervised employment. •Hospitals should make use of their community health workers and community health worker students as healthcare extenders in their facilities.

› Verified 3 days ago

› Url: https://pophealth.health.maryland.gov/Community-Health-Workers/Documents/CHW-Advisory-Committee-Slides-February-16-2021.pdf Go Now

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Opportunities to Improve HIV Prevention and Care Delivery

Details: reduce HIV-related health disparities and health inequities; and 4) achieve a more coordinated national response to the HIV epidemic. Medicaid is the largest payer of HIV care in the United States. 2, and the advent of the Affordable Care Act (ACA) has further expanded Medicaid access

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› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20IV/CMS%20CDC%20HRSA%20HIV%20Prev%20Medicaid%2020116.pdf Go Now

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TRICARE Provider Handbook

Details: Protected Health Information (PHI) only as permitted or required by the HIPAA privacy rule . PHI includes beneficiary-identifiable health details, such as individually identifiable health information. The HIPAA privacy rule permits providers to use and disclose PHI without a patient’s written authorization

› Verified 1 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20VI/Tricare%20Humana%20Military%202020%20Provider%20Handbook.pdf Go Now

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Public Health Services

Details: innovative health care reform in Maryland as a result of the Patient Protection and Affordable Care Act ACA. Public health capacity is the ability of PHS to meet our legislative charges in keeping the water we drink and the food we eat safe, providing preventive health services like tobacco cessation and cancer screenings, and maintaining

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› Url: https://pophealth.health.maryland.gov/Documents/Accreditation/PHS%20Strat%20Plan%20Final%205.9.17.pdf Go Now

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Maryland Loan Assistance Repayment Program (MLARP) for

Details: F. Ultimately, to improve healthcare access and health outcomes across the state for traditionally underserved populations II. Group Brainstorm: Potential future funding sources to meet goals of the Workgroup and those noted by subgroup members above: A. Assessment on insurers 1. MCOs-California 2. Blues-Arizona B. Surcharge on license 1.

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› Url: https://pophealth.health.maryland.gov/Documents/SLRP_MLARP/MLARP%20Subgroup%20-%20Funding%20Structure%20-%204-29-2021%20Meeting%20Minutes%20APPROVED.pdf Go Now

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1. Choose one code from the appropriate Comprehensive

Details: Z00.110: Health Examination for Newborn Under 8 Days Old OR Z00.111: Health Examination for Newborn 8 to 28 Days Old AND Pediatric Body Mass Index (BMI) Z68.51: BMI Less than 5th percentile for age Z68.52: BMI 5th to Less than 85th percentile for age Z68.53: BMI 85th to Less than 95th percentile for age

› Verified 4 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20IV/EZ%20Coder%20Peds-Adol%202017.pdf Go Now

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PCO Regional Meetings

Details: A webinar was held on October 10, 2019 to introduce the concept and purpose for Regional Meetings with the PCO that are expected to begin this fall in each Maryland region. The PCO will travel to meet with you to discuss one-on-one access to healthcare concerns for your area. Discussions will include, but are not limited to:

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Sample 340B Policy & Procedures Manual Page 1 A Guide for

Details: Section 340B of the Public Health Service Act (1992) requires drug manufacturers participating in the Medicaid Drug Rebate Program to sign a pharmaceutical pricing agreement (PPA) with the Secretary of Health and Human Services. This agreement limits the …

› Verified 9 days ago

› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20IV/340B%20Family%20Planning%20Policy%20Procdeure%20Manual.pdf Go Now

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Billing Properly for Behavioral Health Services: Be Part

Details: Billing Properly for Behavioral Health Services: Be Part of the Solution 1 Medicaid is the largest payer for mental health services and plays a significant role in the financing of substance use disorder services.[1] Together, mental health and substance use disorders are referred to as behavioral health services. The

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Coding and Billing Bicillin LA and CR

Details: MARYLAND LOCAL HEALTH DEPARTMENT . RS & F Healthcare Advisors 130 A. DMIRAL . C. OCHRANE . D. RIVE S. UITE . 102 A. NNAPOLIS, M. ARYLAND . 21401 PHONE 410.897.9888 F. AX. 410.897.9889 – BILLING MANUAL 2016. Coding and Billing Bicillin LA and CR. In order to be paid appropriately remember to enter the correct number of Bicillin units:

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› Url: https://pophealth.health.maryland.gov/Documents/Local%20Health%20Department%20Billing%20Manual/PDF%20Manual/Section%20IV/Coding%20and%20Billing%20Bicillin%20LA%20and%20CR.pdf Go Now

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UnitedHealthcare Telehealth Services: Care Provider Coding

Details: United States Department of Health and Human Services (HHS) is exercising enforcement discretion and waiving penalties of HIPAA during the COVID-19 emergency period. Step 1. Use appropriate Office Visit E/M code (99211- 99215) Step 2. Use place of service that would have

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Roster Billing for Mass Immunizers

Details: health clinic CMS created the . Mass Immunization Roster . Biller provider specialty type 73. solely for mass immunizers, who usually cannot enroll in Medicare. Mass immunizers may use . roster billing. Roster billing simplifies submitting multiple beneficiary claims for influenza virus or pneumococcal vaccination. NOTE:

› Verified 9 days ago

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MEDICARE BILLING: FORM CMS15-00 AND THE 837 …

Details: The 837P (Professional) is the standard format used by health care professionals and suppliers to transmit health care claims electronically. Review the chart below ANSI ASC X12N 837P for more information about this . claim format. Form CMS-1500. The Form CMS-1500 is the standard paper claim form health care professionals and suppliers use to bill

› Verified 9 days ago

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Samples of Title X and Health Center Program Sliding Fee

Details: This SFDS meets Health Center Program and Title X Program requirements in one schedule, including the 201%–250% discount for clients only FPL Client fee, % of total bill 100% or less $10 flat fee2 101–138% 20% 139–168% 40% 169–200% 60%. 201–250% 80% 251% or more 100% 1. Integrated services specifies a visit where both health center

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