Table Of Content

s 368.420 P30PHPH 2003 PASSPORT PASSPORT To Health Provider PASSPORT TO/"*««k-^ Health Handbook PASSPORT — ^HeaMr*" MONTANA 151" - NTANA Departmentot Public Health & Human Services MONTANASTATELIBRARY 3 0864 1002 4679 5 This publication supersedes allprevious PASSPORT To Health Provider Handbooks. Published by the Montana Department of Public Health & Human Services, December2003. " » "Manage the delivery of health care to Montana Medicaid clients in order to improve or maintain access and quality while minimizing the use ofhealth care resources. PASSPORT Program Mission Statement o £ X 5L fi> 3 a I c 3 s> 3 V) PASSPORT urn (A To ~ Health » • • Digitized by the Internet Archive in 2011 with funding from Montana State Library http://www.archive.org/details/passporttohealth2003mont Original Page, December 2003 DepartmentoiPublicHealth&HumanServices Table of Contents Table ofContents i.l Key Contacts ii.l PASSPORT To Health Overview 1.1 PASSPORT To Health Program 1.1 3 Program Goals 1.1 S) Getting Questions Answered 1.1 o Client Enrollment and Education 2.1 (ARM Client Enrollment 37.86.5103 - 5104) 2.1 Client Outreach and Education 2.2 Client Education Resources 2.3 Role ofthe PASSPORT Provider 3.1 Becoming a PASSPORT Provider (ARM 37.86.51 12) 3.1 PASSPORT Provider Enrollment 3.1 V Solo PASSPORT provider 3.1 Group PASSPORT provider 3.1 Suitable Coverage 3.2 Normal office hours 3.2 CD Coverage sources 3.2 Vacation, illness, and other absences 3.2 0) Incapacitation 3.2 Direction and education for emergency care 3.3 Role ofthe PASSPORT Provider 3.3 Caseload Limits 3.4 Reporting Changes 3.4 PASSPORT Provider Termination 3.5 Utilization Review (ARM 37.86.51 12) 3.5 PASSPORT Referral 4.1 Primary Care Case Management (PCCM) 4.1 PASSPORT Referral and Approval (ARM 37.86.51 10) 4.1 PASSPORT Approval Number 4.2 Indian Health Services 4.2 PASSPORT Referral Tips 4.2 PASSPORT Referral Form 4.4 Additional Medicaid Requirements for PASSPORT Clients 5.1 Prior Authorization 5.1 Restricted Card 5.1 Table of Contents i.l 1 Original Page, December 2003 PASSPORT To Health Provider Handbook Client Cost Sharing 5.1 Service Limits 5.1 i Managing Your PASSPORT Caseload 6.1 Enrollee List 6.1 PASSPORT Disenrolling a Client 7.1 Disenrollment 7.1 Client Notification 7.1 Emergency Services 8.1 Emergency Services Provided in the Emergency Department 8. Post Stabilization and PASSPORT 8.1 D (D Early Periodic Screening, Diagnosis and Treatment (EPSDT) 9.1 The Well Child Check Up 9.1 Billing and Reimbursement 10.1 3 Reimbursement (ARM 37.86.51 12) 10.1 PASSPORT Billing Tips 10.1 Complaints, Administrative Reviews and Fair Hearings 11.1 Client Complaints 11.1 Administrative Reviews and Fair Hearings (ARM 37.5.310 and 37.86.5120) 11.1 I Non-Discrimination (ARM 37.85.402) 11.2 fi> Definitions and Acronyms A.l T f3i) Index B.l a J c 3 3 (0 O (D (fi i.2 Table of Contents D m >'