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Billing for Clinical Services

Local health departments are facing shrinking federal, state and local budgets. Although public health has traditionally been free, the cost of providing preventive and clinical services such as immunization as well as HIV, STI, and TB testing has been growing for health departments. LHDs play an integral role in the changing landscape of the Affordable Care Act and will continue to provide services for their community.
Even with expanded insurance coverage, gaps will remain and LHDs will need to develop a way to provide services to insured patients as well as those left uninsured. In order for LHDs to be able to provide preventive and clinical services regardless of insurance status, they may need to develop the capacity to bill third party payers. LHDs should be compensated by billing Medicare, Medicaid and private insurance companies for immunization, HIV, STI, TB testing and care, and other clinical services.
This site should serve as a guide and a resource for LHDs in building capacity to bill third party payers for clinical services. Whether your LHD is just starting the process to be able to bill or already has contracts with private insurance companies, NACCHO’s Billing for Clinical Services Toolkit has resources, templates, and manuals to help with your process.

Billing for Clinical Services: Health Department Strategies for Overcoming Barriers

NACCHO recently released the issue brief titled, Billing for Clinical Services: Health Department Strategies for Overcoming Barriers. This brief focuses on billing for clinical services at LHDs and examines the current landscape, what NACCHO is doing to support LHDs, barriers to third-party reimbursement, and strategies overcome these challenges. 

In the Spotlight
Billing Task Analysis Resource

NACCHO and CDC partners developed a Billing Task Analysis Resource to help health departments (HDs) that have varying degrees of knowledge or experience with billing 1) understand the general capacity building process and considerations and 2) easily access tools in the Billing for Clinical Services Toolkit that best meets their informational needs. You can find the Billing Task Analysis Resource here.

NACCHO's Billing for Clinical Services Toolkit
Billing toolki150

NACCHO was funded by the Centers for Disease Control and Prevention (CDC) to create a toolkit with resources, templates, and tools for local health departments to use and develop capacity to bill third party payers for immunization, STD, TB and HIV, and other clinical services. Close to 300 resources have currently been collected from state billing guides, the Centers for Medicare and Medicaid Services, state health departments, local health departments, insurance companies, and vendors of products such as electronic medical records and billing clearinghouses. More »

Billing Training Opportunities

Upcoming Webinars

National STD Services Billing and Reimbursement Toolkit: What’s in it for me?

On October 9 at 11:00 AM ET CDC's Learning Hour Webinar will introduce the National STD Services Billing & Reimbursement Toolkit that houses step-by-step instructions and ready-to-use templates for forms, patient materials, and policies. Tools and resources are available for all stages of billing implementation for STD clinical and laboratory services. The toolkit can help with these questions and many more facing clinic and lab staff with the transition to third-party billing. Click here for more information.

Recent Webinars

Third-Party Billing for Public Health STD Services: A Summary of Coordinated Needs Assessment

The STD-related Reproductive Health, Prevention, Training, and Technical Assistance Centers (STDRHPTTACs) recently released a report based on a needs assessment conducted on third party billing for public health STD Services. Family Planning Council and JSI Research and Training Institute will host a webinar on Wednesday, February 26th at 1 PM ET that will provide participants with an overview of national data collected to determine the current status and capacity for billing for STD services, training and technical assistance needs for STD-certified 340B clinics, state or project area STD programs, and state public health laboratories.

Call in and registration information will be sent via email and posted to DSTDP’s Webinars page soon and the webinar will be recorded and archived by March 5th.

NACCHO's Becoming an In-Network Provider: The Health Department Perspective

The public health system is transforming due to the Patient Protection and Affordable Care Act and the decline in federal and state discretionary funds. Public health departments have started to seek alternative sources of revenue to continue providing services in their community. Many health departments are exploring billing for clinical services provided and are trying to become a contracted in-network provider with health plans.

NACCHO hosted a webinar titled “Becoming an In-Network Provider: The Health Department Perspective” where speakers from Mississippi, New York, and North Dakota shared their contracting experiences. The recording from this webinar is available here and you can find the slides here. Answers to the Q and A section are available here.

More »

Billing News and Journal Articles

Peer Networking Opportunities

The Improving Reimbursement for Health Department Clinics Community of Practice is an online collaboration tool hosted by that allows members to access expertise and share experiences, success stories, tools, and ways of addressing barriers in planning and implementing billing projects. 

The community is open to any program and/or organization interested in billing, and the following documents will explain how to join and how to use the community.

Billing Meeting and Presentations

CDC Billing Stakeholder Meeting, August 26, 2013

NACCHO Annual 2013 

  • Local Health Department Strategies to Address the Affordable Care Act and Implications for Immunization
    • This was a facilitated session on the implications of the Affordable Care Act (ACA) on immunization programs. You can view the presentation here.
  • Building Revenue in Local Health Departments by Billing for Clinical Services
    • This was a panel discussion that addressed the challenges and successes of local health departments in billing for clinical services such as immunization, maternal, child, and adolescent health, and STD/HIV. If you attended NACCHO Annual, you have access to this session for six months. Log in and listen to the session here.

NVAC September 2011

Local Health Departments and the Affordable Care Act

What's the Role of Local Health Departments in Implementing the Affordable Care Act?

If you need more information about The Affordable Care Act and the changes on the way, you can visit NACCHO's Health Reform page.

LHDs in the News

Billing in the News