The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. EPSDT requirements include lead screening, vaccinations, oral health risk assessment, and other required screens and tests for the EPSDT population.
In addition to the EPSDT Dashboard, the Provider Dashboard Report serves to provide PCPs detail on their member data as well as creating opportunities to impact key performance indicators in the effective clinical management of the EPSDT population. The Provider Dashboard utilizes claims data to auto-generate a report which provides a network provider a snapshot of their panel of members in the EPSDT population. It is intended to be an aid in program improvement, benchmarking and other quality improvement strategies. A Physician Dashboard Report is provided to all PCPs quarterly indicating individual members that are due or overdue for an EPSDT well-visit.
Physicians and other providers are encouraged to request assistance from Care Coordination staff at Highmark Health Options to telephonically follow-up with members who need additional education or further explanation about issues, such as the importance of keeping scheduled appointments and obtaining referrals for specialty care. Providers can fax an EPSDT Member Outreach Form to the Organization for the following reasons:
Call Provider Services to learn more about our network and how to join at 1-844-325-6251.