STD Billing and Reimbursement Toolkit

 

icon of a stack of dollar billsDevelop Billing Systems

Covers all aspects related to developing a billing system. Provides sample policies, procedures, and forms that are easily customizable for your clinic/lab, as well as, a section to help you meet your Health Information Technology (HIT) needs.  small star icon indicates recommended tool

First Steps

Tool description Format
10 Steps to Billing: Implementation Checklist and Timeline icon of a yellow star
This organizational tool provides a detailed implementation checklist and a sample timeline outlining a ten-step process to begin billing for STD services. – Region I STD TAC, 2014
PDF
Essential Components of Billing for Sexual Health Services                          *NEW!
This tool will help you identify 14 essential components that your clinic should put in place before it starts billing. – STD TAC, 2015
PDF
Clinic Revenue Projections Tool                                                                    *Updated!icon of a yellow star
This Excel workbook is designed to assist clinics to estimate potential revenue from third-party billing. – Region I STD TAC, 2015
Excel
LAB – Lab Revenue Projections Tool icon of a yellow star
Public health laboratories considering moving to third-party billing can use this Excel Workbook to estimate potential revenue from third-party billing. – Region I STD TAC, 2014
Excel
Cost/Benefit Analysis Tool                                                                                  *NEW!icon of a yellow star
The workbook is designed to assist clinics estimate revenue from third-party billing and the costs associated with billing. Clinics can estimate the costs of in-house or outsourced billing and compare them to estimated revenue. – Region I STD TAC, 2015.
Excel
Obtaining a National Provider Identification Number
Instructions for how to obtain a National Provider Identifier (NPI) for individual providers and organizations. – Region I STD TAC, 2014.
PDF
It Pays to Know Your Cost: Cost Analysis Webinar Series and Tools
This family planning webinar series aims to enhance provider’s understanding and use of cost analysis and its benefits. – Family Planning National Training Centers, 2013
Link
Developing Organizational Buy-In for Billingicon of a yellow star
This tool provides an overview of the role of leadership and organization, and provides tips to help clinics secure buy-in and make a smooth transition to billing. – Region I STD TAC, 2014
PDF
Building Support and Systems for Billing in Public Health Programs
In this webinar, providers will learn about examples of state and local public health programs that have overcome the recent challenges to the implementation and the sustainability of billing in a public health setting. – Cardea, 2013
Link
Sample Memorandum of Agreement (MOA)
This MOA template is designed to assist STD clinics structure a referral agreement with another health care provider for clinical services. [Customizable for clinic needs] – Region I STD TAC, 2014
Word

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Fees and Structure

Tool description Format
Strategies for Effective Fee Assessment and Collection for Clinical Services  icon of a yellow star
This handout offers strategies and considerations for effective fee collection for clinical services, with sample language for written and verbal client communication on financial issues. – Cardea, 2013
Link
Sample Sliding Scale Fee Structure
Sample 10-level sliding fee scale from The Center for Health & Prevention; the scale was informed by a cost analysis. – The Center for Health & Prevention, 2011
PDF
Sample Billing Ledger
A sample spreadsheet to track patients accounts and payments. Includes instructions and data security steps. [Customizable for clinic needs] – Region I STD TAC, 2014
Excel

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Policies and Procedures

Tool description Format
Sample Policies and Procedures  icon of a yellow star
A sample template for written policy and procedures for billing and reimbursement of clinical STD services. [Customizable for clinic needs] – Region I STD TAC, 2014
Word
Sample Cash Control Policy and Procedures
A sample cash policy that includes procedures, guidelines, and explanations for handling, processing, and safeguarding cash payments. [Customizable for clinic needs] – Region I STD TAC, 2014
Word
Sample Co-Payment Policy
A sample co-payment collection policy that describes when and from whom co-payments should be collected and when they may be waived. [Customizable for clinic needs] – Region I STD TAC, 2014
Word
Collecting Co-Pays and Applying Sliding Fee Scales: A Job Aid for Front Desk Staff
This tool reflects the Title X policies for collecting co-pays and applying sliding fee scales in Title-X funded clinics.  – Family Planning National Training Centers
Link
Notice of Privacy Practices
HIPAA compliant; for distribution to patients, this includes details on how personal information may be used, disclosed, and accessed. [Customizable for clinic needs] – Region I STD TAC, 2014
Word
Consent for Services and Acknowledgment of Privacy Practices
A sample patient consent form and acknowledgement of privacy practices document. [Customizable for clinic needs] – Region I STD TAC, 2014
Word
Sample English and Spanish Intake Forms  icon of a yellow star                                            *Updated!
This form is designed to collect client information for the purpose of billing. [Customizable for clinic needs] – Region I STD TAC, 2014
Word
Eligibility and Income Verification
This income verification form from Bridgercare can be used as a sample to determine patient eligibility and verify income. – Bridgercare, 2014
PDF
Insurance Verification Form
Sample tool for tracking insurance verification calls. [Customizable for clinic needs] – Region I STD TAC, 2014
Word
Meeting Data Collection Requirements: Management, Billing and Reporting
Clinics that are initiating or expanding billing can use this document to guide billing and reporting to state and federal funders. – Region I STD TAC, 2014
PDF
Clinic Confidential Billing Algorithm                                                          *Updated!icon of a yellow star
This sample algorithm or flowchart can help clinics identify how to incorporate third-party billing into the clinic protocols while maintaining confidentiality for their patients. – STD TAC, 2016
PDF
LAB – Lab Confidential Billing Algorithm  icon of a yellow star
This sample algorithm or flowchart can help public health labs identify how to incorporate third-party billing into the lab protocols while maintaining confidentiality for their patients. – Region I STD TAC, 2014
PDF
Sample Compliance Plan
This is a sample compliance plan for physician and dental practices. – The Health Plan
PDF

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Patient Communication

Tool description Format
Communicating with Staff and Clients Webinar
The webinar ‘Words Matter: Talking to Staff and Clients About Implementing Billing for STD Services’  explores key messages that leaders can use to make and sustain changes associated with implementing systems to bill and be reimbursed for the provision of STD-related services. – Cicatelli Associates Inc., 2014
Link
Medical Billing Information FAQs                                                            *Updated!
This document provides sample language to answer frequently asked questions patients may have about billing, including definitions of key terms. English and Spanish versions available. [Customizable for clinic needs] – Region I STD TAC, 2014
English

Spanish

Sample Signs and Documents
Sample patient communication materials to communicate changes in payment policy. Includes FAQs, and sample signs for STD clinics. [Customizable for clinic needs] – Region I STD TAC, 2014
Word

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Health Information Technology

Tool description Format
Free EMR/EHR Factsheet                                                                     *Updated!
List of considerations for an STD service provider to select an Electronic Medical Record(EMR) / Electronic Health Record(EHR), including a list of available free EMR’s. – Region I STD TAC, 2014
PDF
How to Implement EHRs 
A step-by-step guide that concerns EHR implementation and achieving meaningful use. – Health IT.gov
Link
EHR Implementation Support 
This site offers assistance for EHR implementation by connecting providers with local Regional Extension Centers (RECs). – Health IT.gov
Link
Electronic Health Records Resource List
The resources in this list assist clinics in preparing for and implementing an EHR system. – Family Planning National Training Center for Management Systems Improvement, 2013
Link

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