POLICY GUIDELINES MANUAL FOR ARTICLE 28 CERTIFIED CLINICS资料.pdfVIP

NEW YORK STATE MEDICAID PROGRAM POLICY GUIDELINES MANUAL FOR ARTICLE 28 CERTIFIED CLINICS Policy Guidelines Manual for Article 28 Certified Clinics Table of Contents SECTION I – GENERAL INFORMATION FOR CLINIC PROVIDERS 3 BASIS OF PAYMENT 3 COMPLETION OF A CLINIC SERVICE 3 PRIOR APPROVAL AND AUTHORIZATION 4 OUT-OF-STATE CARE 4 DOCUMENTATION OF SERVICES PROVIDED 4 PROPER BILLING REQUIREMENTS FOR CLINICS 5 RECORD-KEEPING REQUIREMENTS 5 ANTI-KICKBACK ADVISORY 6 SECTION II – HOSPITAL OUTPATIENT DEPARTMENTS, DIAGNOSTIC AND TREATMENT CENTERS, EMERGENCY ROOMS7 SCOPE OF SERVICES 7 INDUCED TERMINATION OF PREGNANCY 7 ORDERED AMBULATORY SERVICES 8 Who May Provide Services 8 Orders for Services 8 Scope of Services9 Reports of Services10 Payment for Services10 ORDERED AMBULATORY PRODUCTS 10 IMMUNIZATIONS 11 Contact Information13 PSYCHIATRIC SOCIAL WORK SERVICES IN FEDERALLY QUALIFIED HEALTH CENTERS 13 PSYCHIATRIC SOCIAL WORK SERVICES : CLARIFYING QUESTIONS AND ANSWERS 14 Licensure14 Record-keeping 15 Billing15 AMBULATORY SURGERY SERVICES 17 UTILIZATION THRESHOLD PROGRAM 18 SECTION III – FAMILY PLANNING SERVICES 21 BILLABLE FAMILY PLANNING SERVICES 21 PATIENT ELIGIBILITY 22 Medicaid Verification System Information22 PATIENT RIGHTS 23 STANDARDS FOR PROVIDERS 23 REQUIREMENTS FOR PAYMENT 23 STERILIZATIONS 24 Sterilization Requirements 24 Informed Consent 24 Waiting Period 25 Minimum Age 25 Mental Competence 25 Institutionalized Individual 25 Restrictions on Circumstances in Which Con