Priority Health - Updates for Medicaid Members on Immunizations and Well-Child Visits

May 21, 2020

Beginning the week of May 18, 2020, we’ll be reaching out to Medicaid members, or guardians, who are due for immunizations, asking them to schedule these appointments with their primary care providers (PCPs).

We’re also resuming sending reminders for well-child visits. These reminders are sent quarterly via letter or email and ask members, or guardians, to schedule the appointment with their PCP.

Immunization campaign

We’ll be reaching out to two groups of members with phone calls from our customer service team:

  • Members who are currently two years old and are past due for immunizations
  • Members who will turn two on or before Dec. 31, 2020 and are due for immunizations

Well-child letters/emails

We send quarterly reminders to members who are due for a well-child visit at the following ages:

  • 0 - 2 years
  • 3 - 6 years
  • 7 - 12 years
  • 13 - 17 years
  • 18 - 21 years

Reminders include an enclosure with information about the visit and what to expect.

 

Learn more about well-child visits.

What if I’m not scheduling well-child visits or appointments for immunizations right now?

We recognize that some practices may not be prepared to schedule routine appointments due to COVID-19. In our member communications, we’re reminding members that they can call your office back at a later time to schedule the appointment.  Members who are due for well-child visits will remain on our quarterly mailing list until the visit is completed.

 

Can well-child visits be performed via telehealth?

In response to COVID-19, we’re allowing providers to bill routine practices codes for services provided through telehealth. Visits must follow the guidelines of each code, which means providers cannot bill codes that specify an in-person visit or describe services that can only be performed in-person.

Because well-child visits include services that can only be performed in-person, these visits cannot be performed via telehealth.

 

Learn more about telehealth billing and coding guidelines in response to COVID-19.