Notifications for Providers
To keep up to date on all Coronavirus (COVID-19) news and updates please see the following notifications:
- COVID-19 Home Care Provider Enhanced Rates Notice (5/20)
- DC Health Guidance for Universal Masking and Healthcare Personnel Monitoring, Restriction and Return to Work (5/13)
- COVID-19 DME Provider Notification (4/8)
- Updated Telehealth Billing Guidance during COVID-19 Containment Activities (4/6)
- COVID-19 Home Care Notification (3/25)
- COVID-19 Pharmacy Access Notification (3/17)
- Department of Health Care Finance (DHCF) Notice to COVID-19 Medicaid Providers (3/16)
- HSCSN Telehealth Update (3/12)
- HSCSN's Coronavirus Resource Page
- Provider Pharmacy Formulary Notification
- Visit HSCSN's Pharmacy Formulary page
- District of Columbia Prescription Drug Monitoring Program Notification
- No Shots, No School [PDF - 1.79 MB]
Learn more about the campaign to encourage required physical exams and vaccinations for students before the start of the 2018-2019 school year.
Summer Program Benefit 2020
- Summer Program Authorization Form [PDF- 234 KB]
- Claims Denials for Invalid Diagnosis for Age of this Member [PDF- 465 KB]
Notice about submitting claims with the correct diagnosis or procedure code.
- Notification of change to authorization summary [PDF- 665 KB]
Notice about changes to HSCSN's authorization summary document for speech therapy, occupational therapy, and physical therapy
- Provider payment cycle change [PDF- 625 KB]
Notice about further improvements to the provider claims payment cycle
Prior Authorization Update- Incontinence Supplies [PDF-569 KB]
Notice about HSCSN's decison to remove the prior authorization requirements for incontinence supplies and nebulizers
Prior Authorization enforcement notification [PDF- 694 KB]
Notice about HSCSN's enforcement of prior authorization requirements
HSCSN’s Utilization Management Department has a new fax number for inpatient admission notification. Beginning March 1, 2020, all admission notifications, clinical reviews, requests for discharge coordination and discharge summaries should be faxed to (202) 407-8955 or e-mailed to firstname.lastname@example.org.
- Department of Health Care Finance Timely Access Standards for Non-Physician Services [618KB]
- Affirmative Incentive Statement [PDF-598KB]
- Notification about HSCSN's Inpatient Utilization Review Process [PDF- 628KB]
- Notification for Respite Care Providers [PDF- 396KB]
Notice about change in authorization process of respite care services
Applied Behavior Analysis
- Modification to the Provider Agreement with HSCSN [PDF- 833 KB]
Notice regarding ABA behavior specialist/technician requirements
- Provider Request Form for ABA Evaluation [PDF - 681 KB]
Request form for a request for an ABA evaluation
- UM Medical Necessity Documentation Form for ABA Services [PDF - 637 KB]
Documentation form for a request for ABA services
- Enrollment in DC Medicaid Program Required by April 30, 2020 [PDF- 1.1MB]
Notice for all Medicaid Managed Care Behavior Health Network Providers
EPSDT Health Check
Pediatric mental health and maternal depression screening coverage and tools [PDF- 600KB]
DHCF Notice regarding Behavioral Health screenings
- Medicaid Pharmacy Providers: Antiretroviral Carve Out [PDF- 200 KB]
Notice about expanded access to HIV antiretroviral medications through DC Medicaid Fee for Service pharmacy providers.
- HIV Services in the District of Columbia [PDF- 345 KB]
Services ranging from HIV testing locations to medical care, medications and support services, including nutrition services and housing.
Progesterone shots health action information sheet [PDF- 288 KB]
Information about Progesterone shots for expecting mothers
- CDC Notification regarding the Serogroup B Meningococcal Vaccine [PDF- 193 KB]
Notice about the vaccine including risks, benefits, and resources to learn more.
- DC Health Notification regarding Measles MMR Vaccine for DC schools [PDF- 125 KB]
Notice about the immunization of children in DC schools.
- Top Ten Tips for HPV Vaccination Success [PDF-167KB]
CDC Fact Sheet about ways to increase HPV vaccination rates