Examinations
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
Preventive, well-child screening exams must include:
- A complete health and development history, including mental health development (risk assessment)
- A head-to-toe unclothed physical examination, including assessment of physical growth
- A vision screening
- A hearing screening
- Identify dental health, screening of fluoride supplementation and applied varnish, as appropriate
- Nutritional assessment and counseling
- Laboratory tests appropriate to age and sex, including tests for anemia, diabetes and urinary tract infections
- Tuberculosis screening/testing, as indicated
- Testing for sickle cell trait, when appropriate
- Lead screening/testing, as appropriate
- Immunizations, if needed
- Additional tests or exams, if needed
- Health education and anticipatory guidance appropriate to the person's age and health status
- Weight assessment by BMI percentage and counseling intervention, as appropriate
- Counseling for physical activity
The primary care physician (PCP) must provide the member and the member's parent or guardian with a copy of the member's examination results and an explanation of results in terms of needed diagnosis and treatment.
All children with dental problems must be referred directly to a dentist for care. All members ages three and older must be referred annually for preventive dental care to a dentist that accepts Denti-Cal, regardless of whether a dental problem exists. Providers or members may contact Denti-Cal for a list of three Denti-Cal providers within the requester's ZIP code. Providers may also call their affiliated health plan's provider inquiry units for directions on dental referrals and dental networks.