Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Anthem Blue Cross and Blue Shield (Anthem) is committed to ensuring members receive age-appropriate preventive health services. HealthCheck is Wisconsin's name for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program. Each month we send PCPs a list of panel members who, based on our claims data, may not have received EPSDT services according to schedule. We also mail information to these members encouraging them to contact their PCP to set up appointments for needed services.
Specific services needed for each member are reported on the list, which is based only on services received while the member was enrolled in an Anthem plan. The list is generated based on claims data received prior to the date printed on the list. In some cases, services may have been provided after the report run date. To ensure accuracy in tracking appointments for preventive services, please submit a completed claim form.
In addition, services must be rendered on or after the due date in accordance with federal and state EPSDT guidelines. To increase the flexibility of the complicated Childhood Immunization Schedule, the Advisory Committee on Immunization Practices (ACIP) recommends vaccine doses administered up to four days before the minimum interval or age be counted as valid. This does not change the recommendation for routine vaccination but rather makes an allowance that should be considered when evaluating records after a child has been vaccinated.
Review your Provider Manual for more information on HealthCheck or contact Provider Services for assistance.
- Impact of the COVID-19 pandemic on adolescent vaccinations: projected time to reverse deficits in routine adolescent vaccination in the United States
- HPV Vaccination and the Risk of Invasive Cervical Cancer
- Human papillomavirus vaccine efficacy against invasive, HPV-positive cancers: population-based follow-up of a cluster randomized trial
- HPV Vaccination at 9-12 Years of Age
- Starting HPV Vaccination at Age 9
- American Cancer Society resources: HPV Vaccination and Cancer Prevention | ACS
- CDC resources: HPV Resources, Education, and References | CDC
- National HPV Vaccination Roundtable resources: Resource Library – National HPV Roundtable
- Resources for nurses
- HPV Vaccination Resources for Health Professionals
- Steps for Increasing HPV Vaccination in Practice An Action Guide to Implement Evidence-based Strategies for Clinicians