School Health Services Program Manual - General Information - Colorado Department Of Education - Department Of Health Care Policy Page 6
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8School Health Services Program Manual Section 1
In addition, the district must retain service logs, clinical notes, attendance records,
transportation logs and other relevant documentation that support claims for Medicaid
school health services, including the following details:
Date of Service
Service Provided
Provider Type
Location
The SHS Program adheres to the
Centers for Medicare and Medicaid Services (CMS)
Healthcare Common Procedural Coding System (HCPCS) to identify Medicaid services
and the Physicians' Current Procedural Terminology (CPT) manual for procedure codes.
The Department publishes a procedure code specific schedule. See Section 2 for further
detail.
1.5 Coordination of Care
Coordination of care shall occur to ensure there is not duplication of services or
activities being provided to a student.
The participating district shall coordinate the provision of care with the
student’s primary health care provider for routine and preventive health care.
The participating district shall refer student’s to their primary care provider,
health maintenance organization or managed care provider for further
diagnosis and treatment that may be identified as the result of an EPSDT
screen or service.
When the student is receiving Medicaid services from other health care
providers and the participating district, the participating district shall
coordinate medical care with the providers to ensure that service goals are
complementary and mutually beneficial to the student, or the district shall
show cause as to why coordination did not occur.
When the student of the targeted population is receiving case management
services from another provider agency as the result of being a member of
other covered targeted groups, the participating district shall ensure that case
management activities are coordinated to avoid unnecessary duplication of
Medicaid services.
The participating district shall inform a family receiving case management
services from more than one provider that the family may choose one lead
case manager to facilitate coordination.
The participating district shall complete and submit to the Department for
approval a Care Coordination Plan for the delivery of TCM services. The
participating district shall have a representative group of parents and
community-based providers, including the local public health department,
EPSDT case managers and any existing school-based health centers to assist
in developing the Care Coordination Plan.
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