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Billing for Clinical Services

This is an archived project. NACCHO is committed to maintaining the resources on this site but will not be making updates.

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 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 »


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