Interventions and reminders
Independence Blue Cross sends periodic reminders to members about preventive screenings. These reminders encourage members to play an active role in their health care and take the time to get the following screenings:
- Colorectal screening
- Mammography screening
- Pap tests
We developed a one-page cancer screening flyer to help health care providers remind and educate their patients about recommended cancer screenings. This tool provides recommendations for colorectal, prostate, cervical, and breast cancer for men and women at average risk. The information is adapted from nationally recognized health resources and is routinely updated to help keep our members informed and in good health.
Lead testing and developmental screening
Lead testing and developmental screenings are extremely important, especially in young children. The Pennsylvania Department of Human Services (DHS) and Healthcare Effectiveness Data and Information Set (HEDIS®) specifications recommend that children should receive testing for elevated blood lead levels (EBLL) and developmental screening as recommended below.
Screening recommendations and documentation
Practitioners are encouraged to follow the Medicaid and Bright FuturesTM guidelines for lead testing and developmental screening. A lead blood test should be completed at ages nine to 12 months and, again, by age 24 months. Formal screening for developmental disorders using a standardized and validated screening tool should be completed for children who turn one, two, or three years of age, even when there are no concerns. Screening should be completed more often if there are concerns or additional risk factors. Examples of validated screening tools are available on the Bright FuturesTM website:
Use CPT® code 96110 to report the completion of developmental screenings and add screening documentation to the member’s chart.
These screenings are especially important for children enrolled in the Children’s Health Insurance Program (CHIP) because of the higher incidence of developmental delay among certain pediatric populations enrolled in government-sponsored programs when compared to children enrolled in privately insured plans.
The Philadelphia Department of Public Health offers a brochure that outlines recommended developmental screening tools, FAQs, billing tips, and screening workflow recommendations. Referral forms and an overview of Early Intervention agencies are also available for children in Philadelphia county.
Philadelphia residents can view the Check and Connect Brochure for more information.
Providers can refer children who have been identified with a suspected developmental delay to one of the local Early Intervention agencies listed below. Families and providers who have questions about a child’s development may also call the CONNECT Helpline: 1-800-692-7288.
|County||0–3 years of age||3–5 years of age|
|Bucks||Bucks County Early Intervention
|Bucks County Intermediate Unit #22
|Chester||Early Intervention Unit
|Chester County Intermediate Unit
|Delaware||Office of Early Intervention
|Delaware County Intermediate Unit
610-938-2830 ext. 6502 or 6503
Elwyn — Chester SEEDS
610-872-4590 ext. 6502 or 6503
Chester-Upland School District Only
|Montgomery||Office of Early Intervention
|Montgomery County Intermediate Unit
|Philadelphia||Department of Behavioral Health and Intellectual disABILITY Services
Identifying CHIP members
All CHIP members are enrolled in the Keystone Health Plan East HMO program and their Independence member ID cards contain the words, “PA KIDS” on the front as shown below.
Health and well-being for families
Independence members can find information about important health issues and services to improve the well-being of their families:
- Nutritional counseling
- Physical and emotional health resources
- Behavioral health benefits
- What you need to know about opioids/resources
According to the Centers for Disease Prevention and Control (CDC), “chlamydial infection is the most frequently reported infectious disease in the United States, and prevalence is highest in persons aged ≤24 years.” Left untreated, chlamydia can cause serious pelvic inflammatory disease (PID), ectopic pregnancy, and infertility.
The CDC states, some women who receive a diagnosis of uncomplicated cervical infection already have subclinical upper-reproductive–tract infection. The CDC also reports that asymptomatic infection is common in both men and women. To detect chlamydial infections, health-care professionals frequently rely on screening tests. Annual screening is recommended for all sexually active adults and children.
Health care professionals are encouraged to refer to the Preventive Services Task Force Guidelines for details of screening recommendations. They can also refer to our Medical Policy Statement for coding details.