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.
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
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. More »
NACCHO's Billing for Clinical Services Toolkit
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
The University of South Florida's Center for HIV Education and Research is hosting a webinar on Wednesday March 26, 2014 from 9:00 am- 10:30 am (EDT) that will cover HIV testing recommendations, Florida insurance plans HIV testing coverage, CPT codes, ICD-10 diagnosis codes, coding scenarios, and recommendations for sustaining an HIV testing program. You can register here.
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.
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.
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 Meeting 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
Billing in the News