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Automated-Health Systems
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in Health Service Management
EPSDT

Family
Over two million children under the age of 21 have received comprehensive preventive health services through the programs we have administered.

Since the late 1970s, AHS' overall goal has been the promotion of health. The pursuit of this goal has been manifested in the development, implementation, and management of quality EPSDT programs for Medicaid eligible infants, children, and adolescents. Over two million children under the age of 21 have received comprehensive preventive health services through the programs we have administered in six states.

Encompassing all the elements of a complete EPSDT program (see second chart below), our effort in Pennsylvania produced the model used for all of our EPSDT administration contracts and has been our largest EPSDT endeavor. Contracting for these activities with multiple states since 1980, we have developed a system that coordinates all aspects of the program and centralizes operations by establishing a sole point of contact for all Medicaid consumers, agencies and providers. Utilizing cutting edge computer systems and applications and state-of-the-art telemarketing-marketing capabilities, including statewide toll-free hotlines for consumers and providers, eligible families are contacted, educated about the program, and linked with a participating provider. AHS assists in scheduling appointments and transportation, and helps in identifying and linking consumers with follow-up care, as needed.


AHS' EPSDT Contracts
Time Period Location Contracting Agency Program
2010 - 2012 Louisiana Department of Health and Hospitals Louisiana KIDMED Program - EPSDT program administration (provider and consumer outreach, appointment scheduling, tracking, etc.)
1998 - 2005 Various Various HMOs EPSDT program development and administration
1994 - 1998 Georgia Department of Medical Assistance Health Check (EPSDT) provider recruitment and consumer outreach
1993 - 1996 Michigan Department of Community Health EPSDT consumer outreach for providers
1993 - 1995 Connecticut Department of Income Maintenance Hartford HealthTrack (EPSDT) administration
1983 - 1986 Indiana Department of Public Welfare EPSDT program development and administration
1982 - 1987 Pennsylvania PA Department of Health Childhood Lead Poisoning Prevention Project
1980 - 2010 Pennsylvania Department of Public Welfare EPSDT program administration (provider and consumer outreach, appointment scheduling, tracking, etc.)
1979 - 1985 Maryland Department of Health and Mental Hygiene EPSDT consumer outreach and appointment scheduling
EPSDT Services Provided
Key Areas PA CT MI IN MD GA LA
Family Outreach and Education X X X X X X X
Consumer Support Services X X X X X X X
Community Awareness X X X X X X
Program Advocacy via Interagency Networking X X X X X X
Staff Recruitment Training and Supervision X X X X X X X
Provider Recruitment Training and Monitoring X X X X X
Quality Assurance X X X
Case Management (automated information & scheduling) X X X X X X X
Referral and Follow-up X X X X X X X
Claims Editing and Processing X X
Statistical Analysis and Research X X X X X X X
Report Generation X X X X X X X
Additional information about AHS’ Louisiana KIDMED contract is provided below.
Louisiana KIDMED

From 2010 – 2012 AHS administered the KIDMED (EPSDT) program for the State of Louisiana. Through this program, participants could access assistance via our Enrollee Helpline through which we provided assistance identifying KIDMED providers, providing linkages to providers, and accessing appropriate services.

As part of this work, AHS also verified EPSDT screening history data, provided appointment scheduling assistance, and conducted extensive outreach initiatives to increase EPSDT rates. KIDMED participants needing additional specialty services could access additional assistance via the Specialty Care Resource Network Helpline AHS operated as part of the CommunityCARE Call Center.

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