SUBSTANCE ABUSE
COPAY
25$
COPAY
25
DOES MEMBER HAVE TO QUALIFY
UNDER 21 AUTOMATICALLY QUALIFY
NAME ONE SERVICE THAT IS PROVIDED
• Specialty care
• Consults
• Counseling
• Clinical and lab tests
HIPAA
THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996
SUBSTANCE ABUSE SERVICE NUMBER
866-781-5094
WHO DO YOU CALL IF YOU HAVE QUESTIONS ABOUT REFERRAL?
CCC
PERIODIC
WHAT AGE DOES COVERAGE STOP
AGE 2
PHI
PROTECTED HEALTH INFORMATION
Requesting and obtaining medications or medical equipment for someone else.
Excessive use of the emergency room (ER) for nonemergency or routine care.
Excessive use of substance that is required to take prescribed from your dr.
WHAT DOES CCC STAND FOR?
CUSTOMER CARE CENTER
ALL MEMBERS MUST SIGN UP FOR EPSDT (TRUE OR FALSE )
FALSE
COVERAGE BEINIG AVAILABLE TO IMEDIATE FAMILY
YES
MHMM... FIND SOMEBODY ELSE TO DO IT
INPATIENT SERVICES GO TO
substance abuse
services at contracted facilities
SERVICES GIVEN IN AN ACUTE CARE HOSPITAL ARE COVERED FOR MEMBERS OF ALL AGES (TRUE OR FALSE)
TRUE
MEDICALLY JUSTIFIED SERVICES ARE NOT PROVIDED TO TREAT IDENTIFIED ISSUES (TRUE OR FALSE)
FALSE
THEY ARE PROVIDED
KIDS WHO DO NOT IMPROVE HAS TO LEAVE OR STAY IN THE PROGRAM?
STAY
WHO IS ON THE PENNY
ABRAHAM LINCOLN
NAME 1 OUTPATIENT SERVICE
Psychiatric diagnostic interview exams
• Group, family and individual
psychotherapy
• Psychological tests
• Rehabilitative behavioral health services
Substance abuse services:
• Social detoxification
• Residential
• Partial hospitalization
• Intensive outpatient program
• Medication assisted treatment services
• Psychiatric diagnostic interview exams
• Group, family and individual
WHEN IS IT NECCESSARY FOR ALL MEMBERS TO RECEIVE THE CARE IN A CONTRACTED HOSPITAL OR DIVISION OF ALCOHOL AND OTHER DRUG ABUSE SERVICES FACILITY?
MEDICALLY NECCESSARY
WHAT DOES EPSDT STAND FOR
EARLY PERIODIC SCREENING DIAGNOSTIC TREATMENT
WHAT DOES OPAC STAND FOR
OUTPATIENT PEDIATRIC AIDS CLINIC SERVICES
NUMBER OF FINGERS ON A HUMAN BODY
9 ..