Toolkits for Providers
The toolkits below explain topics that can be complex and have frequently resulted in payment errors for providers. Many of these toolkits also contain resources that providers can use to educate patients. Similar toolkits are available for Pharmacy topics.
Toolkit Topics
Beneficiary Card Sharing Risks
Educates beneficiaries about the risks and negative consequences of sharing their number with others
- Beneficiary Card Sharing Risks Fact Sheet (PDF) (4 pages)
- Beneficiary Card Sharing Risks Postcard (PDF) (2-sided postcard)
- Beneficiary Card Sharing Risks Educational Video (YouTube-20 minutes)
- Beneficiary Card Sharing Risks Educational Video Handout (PDF) (11 pages)
Documentation Matters Toolkit
Provides detailed information about the importance of compliance in medical documentation
- Documentation Matters Fact Sheet for Medical Professionals (PDF) (3 pages)
- Documentation Matters Fact Sheet for Behavioral Health Practitioners (PDF) (4 pages)
- Documentation Matters Fact Sheet for Medical Office Staff (PDF) (4 pages)
- Medical Records Resource Guide (PDF) (3 pages)
- Documentation Matters Educational Video (YouTube-91 minutes)
- Documentation Matters Educational Video Handout (PDF) (20 pages)
- Documentation Matters Educational Video Case Study (PDF) (20 pages)
- Electronic Health Records Fact Sheet (PDF) (6 pages)
- Electronic Health Records Resource Guide (PDF) (4 pages)
Hospice Toolkit
Explains the Medicaid hospice benefit, with resources for both beneficiaries and providers
- Hospice Fact Sheet for Beneficiaries (PDF) (3 pages)
- Hospice Booklet for Beneficiaries (PDF) (12 pages)
- Hospice Fact Sheet for Providers (PDF) (3 pages)
- Hospice Booklet for Providers (PDF) (22 pages)
- Hospice Checklist for Providers (PDF) (3 pages)
- Palliative Care vs. Hospice Care Infographic (PDF) (1 page)
Medicaid Compliance for the Dental Professional
Information about Medicaid compliance for dental practices, a review of documentation expectations, and how to use dental software as a tool for good documentation practices
- Dental Medicaid Compliance Fact Sheet (PDF) (5 pages)
- Dental Pediatric Best Practices Brochure (PDF) (11 pages)
- Dental Medicaid Compliance Resource Guide (PDF) (9 pages)
- Dental Medicaid Compliance Educational Video (YouTube-90 minutes)
- Dental Medicaid Compliance Educational Video Handout (PDF) (14 pages)
Non-Emergency Medical Transportation (NEMT)
Information on non-emergency medical transportation for both beneficiaries and providers
Nursing Home Toolkit
Information about Medicaid’s nursing home benefit for both beneficiaries and providers
- Nursing Home Fact Sheet for Beneficiaries (PDF) (3 pages)
- Nursing Home Booklet for Beneficiaries (PDF) (16 pages)
- Nursing Home Fact Sheet for Providers (PDF) (3 pages)
- Nursing Home Booklet for Providers (PDF) (14 pages)
Personal Care Services (PCS)
An overview of personal care services and common payment issues for providers
- Personal Care Services Fact Sheet (PDF) (4 pages)
- Personal Care Services Booklet (PDF) (19 pages)
Additional resources that are useful for state program integrity offices:
- Vulnerabilities and Mitigation Strategies in Medicaid Personal Care Services (PCS) (PDF)
Best practices to help states more effectively ensure beneficiary safety and prevent improper Medicaid payments in Medicaid Personal Care Services (PCS). (35 pages) - FAQ on Allowability of Using NPIs for Medicaid PCAs (PDF) (4 pages)
Other Provider Topics
- Provider Self-Audit Fact Sheet (PDF) (2 pages)
- Payment Suspensions Fact Sheet (PDF) (2 pages)
- Medicaid Recovery Audit Contractor Fact Sheet (PDF) (2 pages)