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Elizabeth M. Whitehorn, Director

Healthy Kids Program Physician Access to Health Profiles

The department makes available to enrolled providers a facsimile copy of any child health profile requested via the Provider Eligibility Inquiry Hotline at 1-800-842-1461. The information requested will be faxed back to the requestor.

To obtain a child health profile the provider will need the following information:

  • 9-,10-, or 12-digit Medicaid provider number

    • 9-digit Recipient Identification Number (RIN) or the participant's name and date of birth or the participant's name and Social Security number

Child health profiles include paid claims or managed care encounter information related to preventive child health services (e.g., well child visits, immunizations, lead screenings). The information provided includes the:

    • Date of service

    • Description of service(s)

    • Provider's name

The requesting provider may then obtain a copy of the medical record from the previous treating provider(s) with proper participant consent.

Child health profile information is transmitted to the managed care organizations under contract with the department when a child becomes a beneficiary of the plan.