Policy:

It is the policy of TLBC to make every effort to ensure Ryan White funds are the payor of last resort, and in order to ensure that, all patient pay sources will be billed before the use of any Ryan White funds. It is also the policy of TLBC to comply with the federal requirement that no patient be denied services based on their ability to pay for services.

Procedure:

1. All patients will be screened for primary pay sources upon intake into the clinic and upon presenting for all medical appointments.
2. All services provided to the patient will be entered into the clinic’s medical records system for eventual billing to primary payers.
3. All patients will be provided with an invoice for services rendered at the end of their appointment. Every effort shall be made by front office staff to receive payment from the patient for services rendered.
4. All billed services will be transmitted to and handled by the NGHD’s third party billing administrators.
5. Front office staff will track reimbursements for all insurance billed charges in the NGHD’s electronic records system.
6. Front office staff will prepare a fee report to cover all cash, check and credit card payments for services rendered. The fee report shall be reviewed by the District HIV Director prior to submission to the NGHD Finance Office.
7. Front office staff shall track payments made by individual patients in order to ensure they do not exceed their share of cost over the course of the year.
8. All front office staff, intake staff, and benefits support staff, will make clear to the patient that all billed charges, irrespective of medical office/provider, should be reported to TLBC staff for accounting and applicability to the cap on aggregate charges.