1 Tuberculosis Services To Bill or Not to Bill? Presented by: Lisa Park June 1, 2015.
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Transcript of 1 Tuberculosis Services To Bill or Not to Bill? Presented by: Lisa Park June 1, 2015.
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Tuberculosis ServicesTo Bill or Not to Bill?
Presented by: Lisa ParkJune 1, 2015
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Charging (or not) for TB Services• How to charge for Tuberculosis services is covered
in the VDH Eligibility Guidance Document (EGD) under Non-chargeable Services
• Section Header – Services provided at no charge to the patient
• Health districts may charge patients’ private health insurance
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NO CHARGENo charge to Individuals for assessment, exam or
testing if they are:
• suspected of having or known to have TB disease • contacts of individuals with known active TB• individuals with a newly positive TB skin test
No charge for DOT or DOPT
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CHARGEABLEAssessment, examination or testing is chargeable
when done for other purposes
For example, when needed for• employment• school• admission to nursing facility• admission to group home
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Chargeable-Active TB or LTBI• Treatment of active disease or LTBI may be
charged to the patient or their health insurer
• Districts can charge a flat rate or sliding scale for drugs and diagnostic tests
• Health director determines flat or sliding for all TB tx-must be applied the same for all individuals
• Patients cannot be charged for anything paid for by the Division of Disease Prevention (DDP)
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Revenue vs. Public Health• Patients with suspected or confirmed TB (active
disease or infection) cannot be denied treatment for non-payment
• Patients having difficulty paying should be assessed for a Waiver of Charges as detailed in the EGD
• Eligibility determinations should be carefully reviewed to ensure the household size/income has been appropriately identified
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Revenue vs. Public Health, cont’d• Avoid creating potential barriers to care
• Focus should be on encouraging and facilitating treatment
• Refrain from worst case scenario cost discussions
• Discuss payment plan options at the beginning of treatment before an account becomes past due
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QUESTIONS?