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FY14 Contract Training for Public Health Prenatal Program/Maternity Services Trina Miller Prenatal Program Coordinator Division of Child & Family Health.

21 21 Resources: HHSC Websites CHIP perinatal: http://www.hhsc.state.tx.us/chip/perinatal/index.htm Billing Processes: http://www.hhsc.state.tx.us/chip/perinatal/NewbornClaimsInstruct ions.pdf http://www.hhsc.state.tx.us/chip/perinatal/NewbornClaimsInstruct ions.pdf Vital Statistics Instructions: http://www.hhsc.state.tx.us/chip/perinatal/VitalStatisticsInstructio ns_062807.pdf http://www.hhsc.state.tx.us/chip/perinatal/VitalStatisticsInstructio ns_062807.pdf Hospital Training: http://www.hhsc.state.tx.us/chip/perinatal/training.htm TMHP general inquiries hotline and website: 1-800-925-9126; http://www.tmhp.com/Medicaid/default.aspx

Form h3038pdf

9 9 Enrollment Confirmation Mothers who are eligible for CHIP perinatal coverage with income at or below 185% of the FPIL receive: Enrollment Confirmation Notice, Bar coded Emergency Medical Services Certification Form H3038, and Self-addressed postage paid envelope.

20 20 Failure to Return Form H3038 A new application for assistance is required if Form H3038 is not submitted within 30 days of delivery. Eligibility for Emergency Medicaid must be determined based on current household information. Eligibility for the new application is determined by either hospital based staff or staff at a local HHSC office.

The California sea lion is the mid-sized Oregon otriid. The body is slender and tapering, the flippers are relatively small, and the rear flippers can be rotated beneath the body for moving on land. The short, course pelage lacks dense underfur; when dry, it usually is chocolate brown, but individuals with light-tan pelage are known to occur. The pelage appears black when wet. In older males, the pate is tan.

10 10 Bar Coded Image The advantage of returning the bar coded Emergency Medical Services Certification, Form H3038 is it allows automated linking between Form H3038 and the CHIP perinatal case in the eligibility system

18 18 Inquiry Request Providers email or fax inquiry requests to Melissa Rodriguez’ attention at: melissa.rodriguez.3@hhsc.state.tx.us 1-512-977-6202 or 1-866-291-1260 Inquiry lists must include the following information: CHIP perinatal case number Mom's name Dates of Service Date 3038 was faxed to MAXIMUS

6 6 Emergency Medicaid Needed The CHIP perinatal health plan pays for all covered professional charges for women with income at or below 185% of the FPIL. Medicaid pays for all covered hospital facility charges for women with income at or below 185% of the FPIL who obtain Emergency Medicaid for labor with delivery.

5 5 Health Plan Billing The health plan identification card shows billing to the health plan for both Professional/Other Services Billing and Hospital Facility Billing. Front Back

14 14 Processing of 3038 Once the form is faxed, state eligibility workers have up to 45 days to process it.

3 3 Eligibility CHIP Perinatal covers the unborn child of low income uninsured women, including women who do not meet citizenship requirements and who do not qualify for Medicaid. Many women must obtain Emergency Medicaid to cover the cost of labor with delivery.

The occurrence of the California sea lion along the Oregon coast is seasonal. The primary areas where it comes ashore are Cascade Head, Tillamook County; Cape Argo, Coos County; and Rouge Reef and Orford Reef in Curry County, but it also occurs in Yaquina Bay and at Sea Lion Caves in Lane County and on Simpson Reef, Coos County.

The Northern elephant seal is the largest pinniped carnivore that occurs along the North Pacific coast. The flippers are relatively small, the rear ones directed posteriorly. Its most distinctive feature is the elongated tubular proboscis with a deep transverse cleft among adult males. This proboscis can be inflated and directed into the open mouth to produce vocalizations. Also among males, the neck and chest lose most of their hair and the skin becomes rough and thickened at puberty. The adult pelage consists of course grayish or brownish hairs without any underfur. During the molt, not only is the pelage shed, but the entire cornified epidermis sloughs off in large patches, creating a mottled appearance.

They typically feed at night and during crepuscular hours because their prey migrates toward the surface at dark. They generally rest and sleep on the surface during the day, although they may feed if prey is available.

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Many enter rivers to feed and some individuals migrate far up the larger rivers. These sea lions are superb swimmers and divers. They can stay under water for as long as 20 minutes.

15 15 Verify Receipt of Form H3038 The patient can verify receipt of the Form H3038 by calling: 1-800-647-6558 to verify receipt 1-866-291-1258 to verify the processing status.

8 8 Stream Lined Emergency Medicaid CHIP perinatal clients with income at or below 185% of the FPIL are not required to complete a new application to apply for Emergency Medicaid for labor with delivery. The initial CHIP perinatal application and supporting verification documents are used to determine eligibility for Emergency Medicaid for labor with delivery.

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formh3038, emergency medical services certification

Pacific harbor seals have been observed ashore at 32 sites along the Oregon coast and in estuaries from the Columbia River to Hunter's Island, Curry County. Most are found along the northern coast. They commonly come ashore on estuarine mud flats, sandy beaches, rocky headlands and offshore rocks and islands.

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7 7 TMHP Billing The health plan identification card for women with income at or below 185% of the FPIL have contact information for the Texas Medicaid Health Partnership (TMHP) listed for hospital billing. Front Back

11 11 Completing the Form The physician who delivers the baby typically completes the Emergency Medical Services Certification Form H3038, at the time of delivery. Bar coded Form H3038 or Regular Form H3038.

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The Steller sea lion is gregarious, forming large groups on traditional rookeries and resting areas; at sea it may form rafts of several hundred individuals.

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4 4 Health Plan Pays For Delivery For women with income above 185% and at or below 200% of the federal poverty income limits (FPIL), the CHIP perinatal health plan pays: All hospital facility covered costs, and All covered professional charges. Emergency Medicaid is not required for payment of labor with delivery cost for this income group.

The Northern fur seal is restricted largely to the waters and some insular areas of the North Pacific region. In Oregon, it occurs mostly along the northern coast.

Do you want to enter your opinion about a specific issue into the public record?  Email the Oregon Fish & Wildlife Commission at odfw.commission@odfw.oregon.gov. Can’t find what you need? Visit the ODFW's agency site. Do you need this information in an alternative format or language? Contact 503-947-6042 or click here.

19 19 Inquiry Results Form H3038 located CPC provides Medicaid ID number Provider can bill: Facility charges to TMHP Professional charges to CHIP perinatal Health Plan Form 3038 not located Hospital asks patient to apply for Emergency Medicaid at local HHSC office Form H3038 must be completed and returned before Emergency Medicaid can be certified Patient can be billed if patient does not follow through with application process

Form h3038instructions

Oregon has two sea lion species and three seals. The Steller sea lion, Northern elephant seal and Pacific harbor seal are Oregon Conservation Strategy Species.

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Form h3038online

1 1 Refresher Training CHIP Perinatal-Labor with Delivery Changes Emergency Medical Services Certification - Form H3038

H3038Medicare

The Steller (or Northern) sea lion is the largest member of the family Otariidae. Among adult females and subadult males, the upper body is slim, whereas in adult males it is heavy and muscular. The head is bearlike with a moderate step between muzzle and forehead. The rear flippers are relatively small and can be turned beneath the body for travel on land. The pelage is light buff to reddish brown, slightly darker in the chest and abdomen. Overall the pelage appears darker when wet. However, beneath the water it appears white, whereas the California sea lion appears black.

In surveys along the Oregon Coast, Steller sea lions were observed ashore at 10 sites extending from the South Jetty at the mouth of the Columbia River in Clatsop County, south to Rogue Reef in Curry County.

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The body of the Pacific harbor seal is plump but tapers to small rear flippers permanently extended posteriorly. The head is large and rounded, the eyes are large, the limbs are short, and the nostrils sit dorsally on the muzzle. The nostrils can be closed when this seal dives. The tongue is notched at the tip. The pelage consists of long overhairs that overlay short underhairs. Markings are extremely variable, but in general the pelage is gray or brownish gray with numerous small spots of black that may coalesce to form splotches.

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h3038-p

Except for the time spent on the rookery during the breeding season and a month or so ashore while undergoing the molt, the Northern elephant seal is truly a pelagic mammal. They have set records for the deepest dives recorded for any mammal.

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In Oregon, individual elephant seals reportedly were sited ashore south of Bandon and at Simpson Reef, in Coos County. In addition, they have been found at Seal Rock, Depot Bay, and Newport in Lincoln County, and at the mouth of the Columbia River, Clatsop County.

17 17 Verifying Coverage Prior to submitting an inquiry request, providers with accounts 40 days old or older should contact: Angela McKnight 1-512-533-2954 or Denise Townsley 1-512-533-3581

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16 16 Verification of Coverage Providers can verify PCN/Medicaid number for mom and baby (185% FPL and below): On TMHP web portal: www.tmhp.com Call TMHP help line for assistance 1-800-925-9126

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13 13 Submitting the Form Hospital staff can return the completed form by: Faxing to 1-877-542-5951, or Mailing to: HHSC PO Box 14400 Midland, TX 78711-4400

2 2 Objectives Hospital provider staff: Can describe the process used to cover the labor with delivery costs through Emergency Medicaid for eligible CHIP perinatal mothers. Follow established procedures to check status of H3038. Know processing timeframes from submission of H3038 to payment date.

The Northern fur seal is the smallest member of the family in Oregon. The flippers are nearly twice as large as those of a comparably-sized individual of any other species of otariid. The ears are cylindrical and the auditory meatus is covered with wax to prevent entry of water. The pelage consists of coarse guard hairs and an exceedingly thick underfur that serves as waterproof insulation. Adult males are dark gray or brown dorsally and reddish brown ventrally; a grayish cape covers the neck and shoulders. Adult females are grayish brown dorsally and reddish brown ventrally.

These seals are solitary in the water, but commonly assemble in small groups of mixed sexes and ages when they come ashore. Some seals move great distances whereas others move little or not at all.

Form h3038printable

JOHN W BARCH, MHA SR. DIRECTOR OF CLINICAL OPERATIONS JANET M RIVERA MANAGER, PATIENT MANAGEMENT AND BUSINESS OFFICE BRIANNE E PORCHE, BBA SUPERVISOR OF.

12 12 Cover Sheet Requirements Mother’s name as it appears on the CHIP perinate card CHIP perinate case number Baby’s name Baby’s date of birth Baby’s gender