healthywoman logo

 
HealthyWoman Providers

Notice of Privacy Practices 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Direct Access Information for HealthyWoman Program (HWP)

Providers

 

Form PA600B

Spanish Version of Form PA600B 

 

Direct Access

Women diagnosed by a non-HWP provider receive direct access into the Breast and Cervical Cancer Prevention and Treatment (BCCPT) Program.  This direct method of referring women diagnosed with breast or cervical cancer or precancerous conditions of the breast or cervix outside of the HWP enables women to expeditiously receive the treatment that they need without visiting a HWP provider site. 

The process remains unchanged for HWP providers.  However, the process for those women diagnosed outside of the HWP by a non-HWP provider changed only to the extent that the woman will not be required to come into a HWP provider site to be referred to the BCCPT Program.  The process will be as follows:

  • The woman will complete the HWP Enrollment Information/Consent Form (PA600B, Part A) while she is in the health care provider’s office. 
  • The health care provider’s office who diagnosed the cancer will complete the BCCPT Program Eligibility Application (PA600B Part B).
  • Both forms will be faxed by the health care provider to the HWP Case Management Team at Adagio Health for review, fax 412-201-4702.
  • If necessary, the HWP Case Management Team will contact the woman within two business days to clarify or obtain additional information for form completion.
  • The HWP Case Management Team will fax the completed forms to the County Assistance Office in the county in which the woman resides.
  • If the non-HWP provider does not assist the woman in filling out the Enrollment Information/Consent Form (PA 600B, Part A) form, she will be referred by the health care provider to the HWP Case Management Team at Adagio Health 1-800-215-7494.  These women will be given contact information for the HWP Case Management Team prior to leaving the heath care provider’s office.  

If you have any questions on the information provided, please follow the protocols established by the Alliance of Pennsylvania Councils, Inc. partners.  

  

Quick Links


Free Mammograms and Pap Test

Patients

HealthyWoman Providers

Healthcare Providers