WISEWOMAN and Breast & Cervical Health: For Providers
Billing for Covered Services
Billing for covered services is simple if you follow these basic guidelines:
- Remember that your HCFA (UB 90 or RRB1500) should not be billed until a BCHP Screening form (PDF) and a completed WISEWOMAN Lifestyle questionnaire (PDF) have been submitted for the patient.
- Be certain that you are billing for services that are covered by the program. (See Women's Health Covered Services)
- Keep in mind reimbursement for covered services is at the Medicare Part B rate. In addition, SEARHC Women's Health grant is the payer of last resort; that is, the program pays for net charges after all third-party payments have been received.
Forms and Supplies
If you need covered service cards or brochures, please call our provider support Line at 1-888-388-8782.
Provider forms
- 2006 Eligibility Resource guide (PDF)
- 2006 Income Eligibility card (PDF)
- Breast & Cervical Health Program Screening form (PDF)
- Enrollment & Consent form - 2006 (PDF)
- NCEP ATP III guidelines (PDF)
- SEARHC Patient Registration worksheet (PDF)
- WISEWOMAN Health History form (PDF)
- WISEWOMAN Lifestyle questionnaire (PDF)
- Women's Health Covered Services (PDF)
Additional forms are available via fax; please call our provider support line at 1-888-388-8782.
- ICD-9
- CPT Codes and Schedule of Fees
- SEARHC Health Visit voucher
Patient fact sheets
Screening Protocols and Treatment Algorithms
Below you will find screening protocols for services covered by the SEARHC WISEWOMAN and BCHP programs.
- Summary of SEARHC CVD and Cancer Screening Protocols (PDF)
- SEARHC Breast Cancer Screening Guidelines (PDF)
- SEARHC Cervical Cancer Screening Guidelines (PDF)
- WISEWOMAN Flow Chart for Alert Values (PDF)
- CDC WISEWOMAN Guidelines for Accurate Blood Pressure Measurement (PDF)
- AFP/AHA New Guidelines for Accurate Blood Pressure Measurement (PDF)
Links to independently published clinical algorithms
- Breast: California Department of Health Services/CDC
- Cervical: ASCCP Guidelines
- Cholesterol: ATP-III
- Hypertension: JNC VII-NHLBI
Continuing Medical Education Credit Opportunities
- Cervical Cancer CMEs
- ASCCP and ASHA training courses
- The Natural History and Epidemiology of HPV
- Follow-up after an Abnormal Pap: Addressing Barriers
- The ASCCP Guidelines to Managing AGC
- The ASCCP Guidelines to Managing ASC
- Colposcopy of High Grade Lesions
- Immune Response to HPV
- Cardiovascular Disease Risk Factor CMEs
