Covered and Noncovered Services : Outreach and Case Management Services

Overview

Medicaid-enrolled HealthCheck outreach and case management agencies and HMOs provide outreach and basic case management services to inform and assist members in obtaining HealthCheck services. These agencies may identify when a member has missed a check-up according to the periodicity schedule or may identify health needs through other public health programs such as blood lead screening or nutrition programs.

Case management services are specifically related to helping the member obtain HealthCheck services such as assisting with scheduling, arranging transportation to a HealthCheck visit, or ensuring that appropriate referrals and follow-ups occur following a HealthCheck visit.

Case management is a tool for linking Medicaid-enrolled members to HealthCheck screening services, as well as to health care providers for follow-up and ongoing primary care services. Case management services include the following:

• Informing members about HealthCheck services and assisting them with obtaining those services
• Identifying when members have missed check-ups according to the periodicity schedule
• Identifying members' health needs through public health programs such as blood lead screening and nutrition programs
• Assisting members with scheduling and arranging transportation to a HealthCheck visit
• Ensuring that appropriate referrals and follow-ups occur following a HealthCheck screen
• Removing the barriers to services and resources

Accessing Outreach and Case Management Services

HealthCheck outreach and case management services are available without PA. Medicaid-enrolled outreach and case management agencies or the member's HMO may initiate outreach to the member, or the member can contact these agencies for information and assistance in obtaining HealthCheck screens or services.