Comprehensive Billing Resources
Building Support and Systems for Billing in Public Health Programs (Cardea Services)
This webinar presents examples of state and local public health programs that have overcome these challenges. Participants will hear ideas for building support for third-party billing and developing systems for implementation.
Billing Guide: Shifting to Third-Party Billing Practices for Public Health STD Services: Policy Context and Case Studies (NCSD)
An introduction to policy and other considerations for providers as they approach decisions regarding third-party billing
Don't Reinvent the Wheel: Leveraging Systems, Practices and Lessons Learned in Immunization to Support Billing for STD-related Services
The goal of this webinar is to offer STD program leaders in Region II and IV ideas for collaborating with other programs in innovative ways to leverage resources, systems and information to support the development of billing and reimbursement for STD services
NACCHO Billing Toolbox (National Association of County and City Health Officials)
A collection of tools and resources related to billing (must have a NACCHO username and password to access; create a free account at http://eweb.naccho.org/eweb/DynamicPage.aspx?WebCode=LoginRequired&expires=yes&Site=NACCHO)
National STD Billing and Reimbursement Toolkit
The toolkit is a series of modules designed to walk the user through the third-party billing process for STD services. The modules are organized by topics including: Before you Begin, Develop Billing Systems, Manage Revenue Cycle, Initiate Contract Process, Enhance Coding Capacity, and Access More Resources.
Healthcare Changes and STDs: When the Money Goes, Will the Services Stay? (CDC 2012 National STD Prevention Conference)
A series of presentations from the 2012 National STD Prevention Conference discussing changes in public health STD funding and implications for programs
The High Court Ruled on ACA: What's Next for Public and Sexual Health, Kevin Cranston, Massachusetts Dept. of Public Health (NCSD 2012 Annual Meeting Keynote Presentation)
Impact of the ACA on STD Programs in Massachusetts
The Affordable Care Act: Expanding Medicaid Coverage and Access to Commercial Health Insurance
Impact of the ACA commercial and public health care programs
The Art of Collections (Migrant Clinicians Network)
This powerpoint presentation is a good training tool for collections staff on collections policies and the staff's role in helping to maintain the financial viability of the health center. Suitable for migrant and community health centers. Feel free to adapt the presentation to your individual clinic needs.
Case Studies Webinar Part 1: Philadephia and Portland (NCSD)
These case studies highlight the experiences of STD programs and clinics that are currently billing third-party payers for STD-related services, or are in the process of developing a plan and laying the groundwork to implement a third-party billing practice. These cases studies offer real world examples of partnerships and business models for building relationships with third-party payers.
Case Studies Webinar Part 2: Minneapolis and Denver (NCSD)
These case studies highlight the experiences of STD programs and clinics that are currently billing third-party payers for STD-related services, or are in the process of developing a plan and laying the groundwork to implement a third-party billing practice. These cases studies offer real world examples of partnerships and business models for building relationships with third-party payers.
Moving Toward Third-Party Billing and Revenue Generation in Public Health: An Emerging Model from Michigan (NCSD)
This webinar focuses on the diversification of revenue to ensure the continuation of safety net services are provided, and highlights on Michigan LHD's billing capacity
Third-Party Billing at the Oregon State Public Health Laboratory (Cardea Services)
A guide highlighting the experience of the Oregon State Public Health Lab in implementing billing for STD services.
Addressing Medical Billing Challenges in Public Health (North Carolina's Northwest Partnership for Public Health)
Description of a 2-year public health billing enhancement pilot project among 4 counties in NC (billing clients for STD services is not permitted in the state of North Carolina)
CDC Billables Project for Health Department Immunization Services Reimbursement (CDC)
Webpage for the CDC projec to improve reimbursement for immunization services in public health department clinics; includes project overview and resources
Third-party Reimbursement for Vaccines: Effective Billing Strategies for Public Health Departments (AHIP)
Series of webinars developed by AHIP for public health agencies interested in developing or improving billing for immunization services
California's Innovative Immunization Billing Project Plan (Kern County Health Department)
Description of California's Immunization billing project
NIATx Third-party Billing Guide, Second Edition (Network for the Improvement of Addition Treatment)
A step-by-step guide for developing systems for billing third-party payers
Billing Guide for a local county health department in NC (Buncombe County HD)
Procedural manual specific to the BCHD in North Carolina, including billing and collections policies, program information, sliding fee scales and service fee schedule (billing clients for STD services is not permitted in the state of North Carolina)
Introduction to Coding and Documentation for STD Services (JSI/Region I STDRHTTAC)
Coding Primer: Cross Walk from ICD-9 to ICD-10 (NCSD)
Document mapping out changes between ICD-9 and ICD-10 coding for common STDs
Guidelines for Coding, Documentation and Billing (NC State Public Health Nursing & Professional Development)
Guidelines used by NC DHHS for coding and documentation, including suggested codes by program
Billing Information: Women's Health Screening - Getting Paid for Prevention
Tips for coding common types of women's preventative visits, including case study examples (document references Medicare billing but codes listed are universal)
Coding Basics for Family Planning Professionals (CAI)
Online Module - The goal of this introductory course is to provide a basic foundation for complete and accurate diagnostic and procedural coding in the family planning setting.
Find-A-Code
Website of catalogued code sets, including ICD-9, ICD-10, CPT, HCPCS, etc.
Protecting Confidential Health Services for Adolescents & Young Adults: Strategies & Considerations for Health
Plans (NIHCM)
NIHCM Foundation Issue Brief that discusses the importance of access to confidential health services for adolescents and young adults, and presents opportunities for health insurers to ensure billing processes protect adolescents' and young adults' access to confidential care
Implementing the Affordable Care Act for Adolescent and Young Adults: Practical Considerations (HRSA)
Archived webinar with downloadable slides. Addresses several topics related to adolescent health in light of ACA, including confidentiality. See 2nd presentation, Slides 42-87 (includes examples of policies in NY and CA that protect adolescents' confidentiality)
Confidentiality for Individuals Insured as Dependents: A Review of State Laws and Policies (Guttmacher)
A state-by-state review of legal requirements related to confidentiality in private insurance for individuals insured as dependents
Minors' Access to STI Services (Guttmacher)
Document listing state-by-state regulations for minors' consent for HIV/STI services
Unintended Consequences: How Insurance Processes Inadvertently Abrogate Patient Confidentiality (Guttmacher)
A brief discussing the potential for breeching patient confidentiality as a result of third-party billing and possible approaches for addressing or preventing these breeches.
Revenue Cycle Management: Contracting with Payers (FPNTC)
Webinar 3 -Guides participants through the process of negotiating fee schedules and executing contracts with third-party payers
Technical Assistance Costing Tool (HRSA)
An Excel-based tool that lets providers identify costs for providing HIV/AIDS services; may be useful as a template for costing other services
Cost Analysis Tool/Template (CAI)*
*Contact your regional STD TAC coordinator at CAI to request this tool
Excel-based tool(s) that may be customized for specific health centers in conducting a Cost Analysis
Applying for Credentialing (BCBS of North Carolina)
Information on the credentialing process for BCBS of NC
Health Care Professionals: Joining the Network FAQs (Aetna)
Information on the credentialing process for Aetna networks
Georgia Uniform Credentialing Application (GA DPH)
Documents used for credentialing providers in Georgia (updated 2007)
Illinois Department of Public Health Credentialing Form (IL DPH)
Documents used for credentialing providers in Illinois (updated Jan. 2002)
Reimbursement and Credentialing Information for ARNPs (Kentucky Providers Coalition of Nurse Practitioners and Nurse Midwives)
Summary of credentialing policies and reimbursement rates for NPs among various insurance providers in KY
Improving Reimbursement for Health Department Clinics (phConnect - Collaboration for Public Health)
Web-based Community of Practice created by CDC's Billables Project for Immunization, but includes links to resources and discussion boards that are helpful to other programs
Credentialing Documentation List (ADPH)
Document created by Alabama DPH that lists which documents should be sent as part of the Application Credentialing Package for various insurance companies
Essential Community Providers FAQs (CMS)
Frequently Asked Questions about essential community providers (ECPs) answered by the Centers for Medicare and Medicaid Services
How to Implement EHRs (Health IT.gov)
A step-by-step guide on how to implement EHRs
Get EHR Implementation Support (Health IT.gov)
Local assistance for EHR implementation support from Regional Extension Centers. Funded by the Office of National Coordinator for Health Information Technology (ONC), can serve as a two-way pipeline to local and federal resources
Public Health Grand Rounds: "Electronic Health Records: What's in it for Everyone?"
(CDC Public Health Grand Rounds)
Web presentation that explores issues of EHR implementation with particular attention to public and population health while addressing concerns of cost, patient confidentiality and other challenges
Transitioning to Billing Part 1: Assessing your Capacity to Successfully Manage Revenue as a
Key Element of Agency Sustainability (JSI)
The webinar is geared toward state and local STD program and public health laboratory directors/managers, as well as executive and middle management of community-based organizations (CBOs) providing HIV prevention services
Transitioning to Billing Part 2: Best Practices for Successful Reimbursement –Implementing Effective Revenue Cycle Management Practices as a Key Element of Agency Sustainability (JSI)
The webinar is geared toward state and local STD program and public health laboratory directors/managers, as well as executive and middle management of community-based organizations (CBOs) providing HIV prevention services
Revenue Cycle Management: Before and During the Client Visit (FPNTC)
Webinar 1: Identifies the key components of the revenue cycle management process that should take place before a client's appointment and when the client arrives
Revenue Cycle Management: After the Client Visit (FPNTC)
Webinar 2: Provides a framework for the billing and collections process that takes place after the client is seen
Managing Family Planning Revenue Cycles (NFPRHA)
NFPRHA's provides case study and companion workbook with detailed examination of how family planning providers can streamline billing practices as they serve an increased number of newly insured patients.
