Children and Youth with Special Health Care Needs Program Provider Manual

Table of Contents

• Children and Youth with Special Health Care Needs (CYSHCN) Program Description
• CYSHCN Program Philosophy
• Core Values
• Special Health Care Needs (SHCN) Mission
• Contact Information
• Provider Enrollment/Application
• SHCN Provider Monitoring
• Confidentiality
• Billing/Claim Procedures
• Special Health Care Needs (SHCN) Claims Submission Guidelines for CYSHCN Program
• Prior Authorization
• Covered Services
• Children and Youth with Special Health Care Needs (CYSHCN) Program Reimbursement Rates
• Non-Covered Conditions
• Non-Covered Services/Supplies/Durable Medical Equipment (DME)
• Coverage Restrictions
• Non-Covered Providers/Specialists
• Appeal Process