Ped-I-Care is a health plan for special needs children operating under the auspices of the University of Florida College of Medicine’s Department of Pediatrics. It functions under a contract with the Department of Health’s (DOH) Children’s Medical Services (CMS) Division. CMS designated this contracted service as a Pediatric Integrated Care System (ICS).
This ICS is known as Ped-I-Care, and it provides care to children with special health care needs from the age of one year until the child reaches his/her nineteenth birthday. It is implemented in collaboration with the local CMS offices, which continue to provide nurse care coordination for the members and providers as well as on-going support for the pharmacy benefits program.
Translation services are available for members. Additionally, written materials may be provided in various languages. Braille and audio services are available when necessary.
In The News
UF Ped-I-Care was nationally recognized for innovation in improving community health. Read the article.
Changes to Ped-I-Care Claims Submissions
Ped-I-Care’s Third Party Administrator (TPA), MED3000, has entered into a relationship with Emdeon, a leading provider of revenue and payment cycle management. Due to this relationship, there will be changes to Ped-I-Care claims submissions, for both Title XIX (T19) and Title XXI (T21) paper and electronic claims.
Updates In Pediatric Pulmonary Care 2012
April 13, 2012 - Dr. Michael Boyle is a nationally known expert in CF clinical care and research. He will be talking about these and specifically about targeting treatment to specific CF genetic mutations. Please join us to hear this exciting speaker and to learn more about other pediatric pulmonary conditions.
Med3000 recently performed upgrades to eINFOsource that include changes to search functionality and services authorization submissions. View the summary of changes. If you have questions or would like to schedule refresher training on the use of the provider portal please contact Med3000 by calling 1-866-703-1444.
Please visit News and Information page under quick links for current events and updates.
EHR Incentive Program (Meaningful Use) Provider Workshops
AHCA and your local Regional Extension Center are hosting Eligible Professional workshops throughout the state for an opportunity to work one-on-one with providers. Agenda topics include an overview of program requirements, an understanding of Meaningful Use measures, available services to assist you, and a preview of Stage Two requirements. Workshops are scheduled through March and April. Register now to reserve your spot.
Performing a blood test for lead levels is a Federal and State requirement at specific intervals during the Child Health Check-Up (CHCUP). CMS/Ped-I-Care Title XIX Medicaid Reform children are covered by the same Federal and State requirements as other Medicaid children.
The Federal regulation as referenced in the Child Health Check-Up Coverage and Limitations Handbook, October 2003, pages 2-13 and 2-14, and pages 3-6, requires that all Medicaid children receive a screening blood lead test at the ages of 12 months and 24 months, and between the ages of 36 months and 72 months if they have not been previously screened for lead poisoning. When you order the blood lead test, it needs to be documented in the medical record. The result of the test also needs to be documented.
To meet the Medicaid requirement a blood test must be done. Performing a risk assessment alone does not meet this requirement. Whether you draw the blood in your office or you send the member to the lab, your office should report the additional ICD-9 code V82.5 for the blood lead screening test.
The Child Health Check-Up Coverage and Limitations Handbook can be accessed by visiting http://mymedicaid-florida.com. Click on Public Information for Providers, Provider Support, then Provider Handbooks, and select the Child Health Check-Up Handbook.
If you have any questions or need a list of members assigned to your practice that are under 3 years old, please feel free to contact us at (866) 376-2456.