Billing & Reimbursement
Collection of tools on third-party billing and reimbursement and calculating the cost of care.
Webinars and Training
HRSA HIV/AIDS Bureau (HAB)January 2019
The Imposition of Charges requirement is a term used to describe all activities, policies, and procedures related to assessing RWHAP patient charges as outlined in legislation. The HRSA RWHAP statute defines who MUST NOT have a charge imposed, who MUST have a charge imposed, and limits the amount that CAN be imposed in a calendar year.
CRE TA Center, National Center for Innovation in HIV CareMay 2016
Review of strategies for agencies to undertake to get ready to bill for their services in order to enhance their financial sustainability, including how to assess feasibility for billing, various billing models, and actions for organizations to take to put billing systems into place.
Training resources on enhancing billing systems to maximize revenues, covering CPT and ICD codes in the HIV/AIDS care context.
Tools and Job Aids
CRE TA CenterMay 2017
Tips to help Ryan White HIV/AIDS Program providers to take concrete steps to improve their contracting and billing processes.
CRE TA CenterMarch 2016
Tool for conducting a cost analysis: the process of determining the unit cost or the average cost of providing specific services over a defined period of time in order to use this information to bill and secure reimbursement for services provided.
CRE TA CenterSeptember 2015
Tool for assessing organization regaring areas of importance to insurers and that support maximizing revenue from contracting activities.
CRE TA CenterMarch 2015
This Roadmap can help you navigate resources that deal with contracting, billing and enrollment with Medicaid and Marketplace Insurance Plans.
West County Health CentersMarch 2013
Form for clients explaining the maximum annual amount of costs patients will incur for RWHAP services they receive.
Reports and Best Practices
Sustainable Strategies for RWHAP CBOsMay 2018
This needs assessment was conducted by Primary Care Development Corporation (PCDC) as part of the Sustainable Strategies for Ryan White HIV/AIDS Program (RWHAP) Community Organizations technical assistance project.
Fact sheet to explain policies and procedures for ADAPs to follow to ensure that Ryan White funds are used as the payer of last resort, including for Medicaid.
Summary of survey findings on third party billing practices of state health departments and their local providers, with an action step chart for health departments in building the billing capacity of agencies.