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Develop 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. 
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First Steps
| Tool description | Format |
|---|---|
| 10 Steps to Billing: Implementation Checklist and Timeline 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 |
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| 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 |
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| Clinic Revenue Projections Tool *Updated! 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 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! 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. |
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| 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 Billing 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 |
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| 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 |
Fees and Structure
| Tool description | Format |
|---|---|
| Strategies for Effective Fee Assessment and Collection for Clinical Services 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 |
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| 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 |
Policies and Procedures
| Tool description | Format |
|---|---|
| Sample Policies and Procedures 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 *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 |
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| 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 |
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| Clinic Confidential Billing Algorithm *Updated! 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 |
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| LAB – Lab Confidential Billing Algorithm 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 |
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| Sample Compliance Plan This is a sample compliance plan for physician and dental practices. – The Health Plan |
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 |
| 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 |
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 |
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| 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 |
