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.
In the Spotlight
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 services. More than 200 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.
Billing Training Opportunities
JSI Billing Webinar Series
As agencies shift from relying on grants to billing payers for their services, they must assess and analyze their capacity to manage revenue through billing third-party payers. This webinar will introduce protocol, procedures, and infrastructure that agencies must consider prior to seeking reimbursement through third-party payers, as well as the cultural shifts that must occur to ensure success. Click here to register for Part 1.
Claims submission, billing, and collections are often considered the key components to receiving reimbursement; however, revenue cycle management is much more than submitting a bill. This webinar will build upon Transitioning to Billing 1, and provide specific details and strategies necessary to effectively receive reimbursement from third-party payers through managing revenue. Click here to register for Part 2.
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 will be available soon.
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 phConnect.org 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 Meetings and Presentations
CDC Billing Stakeholder Meeting, August 26, 2013
NACCHO Annual 2013
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