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� <br /> -�~~ <br /> � <br /> � <br /> 30D W.Tryon Street <br /> Hillsborough.m�u727B <br /> County ��o "* m�chapL`Hill line o68-450t <br /> Mebane m`" zu'eouc <br /> 0�K"��� ������8����������^�' nw^anv"e emmn� <br /> oxw^*nu°m nm =,"�° ~ ^.~ ~ ~~---'- - <br /> o",,Mill Mall—Suite ao <br /> `oomm.m"rt>omStreet <br /> � Canbory mC_os,u <br /> 942-416B <br /> M E M 0l <br /> jerry no*;riscri.MAp& <br /> ' <br /> Director <br /> ^ <br /> TO Board of Health _ <br /> / <br /> FxoH: Jerry Robinson _ <br /> DATE: 'September 11, 1980 _ <br /> RE- Expanding the Departmental Fen System <br /> BACKGROUND <br /> On August 26' 1980 <br /> , I attended a workshop held by the Office =f' Ad <br /> miniot <br /> r <br /> a <br /> - <br /> ti«u procedures, Division of Health Services (DH5)' The subject was w `nemuranomx <br /> of Understanding for Title XlX' between the Division opMedical Aaalotunoe (DMA) <br /> .,and DHS' The schedule of future workshops will cover "....clinic flow to maximize <br /> earned income, and the process for billing Medicare/private carriers for covered <br /> services." <br /> From Title XIX (Medicaid) we obtain $2/000 in family planning funds and <br /> ' i Diagnosis and Treatment srrvIuuo {CPSDT}~ <br /> ' $o62 in Early and p�r�»dio Sn��e"�ng'n��agn o a badly developed program for eligible <br /> The small [P5pT co��e��z�no a�� uymy� " os�' � ~ig�blo D5S case load children <br /> participate in this program. Our <br /> o���dzen, State figures'show'le than � t and�thv eligible pg5 n=ods to develop <br /> ' department <br /> this effort, We are. entitled to bill for ,approved mc6loel clinical services" but <br /> ^t <br /> budget �ur this �� - <br /> are not doing �o yp�' However, our aool year (July �, 1�a� <br /> 3unr 30` 1981) contains an item. to collect $12°716 in fona f or 'other <br /> clinical <br /> services'. Lastly Title XzX ploys an unknown factor in our d*nra l fees which <br /> 1"o, and <br /> can <br /> are u»ugec=d at $22`a43 (we started charging dental fnnn on July 1, <br /> not yet predict the extent to which Medicaid will contribute to thefer need). <br /> d that the effective date of the Memorandum of Understanding <br /> � I� was announced <br /> is J 198V0 The nHS representative <br /> stated that DMS would not ewwh to l <br /> i <br /> ti <br /> - <br /> p lz=nQu based on our agreement to sign the Memorandum October 1. <br /> gate ournon comne"do �o h~ ~^g`~d by -'-el� (and in order to do =o I need th e <br /> Th e Memorandum and by Neal E»ono` Orange County Finance Director <br /> Board's action on September 1n) mmiaa1nnezo` approval on <br /> (and in order For him to sign he needs the County Cc <br /> September 22)' Should we fail to sign, it is possible that the Medicaid program <br /> uI6 seek restitution of funds to some unknown point in our past history. Should <br /> cc <br /> a <br /> h ve �n �no� boen out <br /> we sign we could still be subject to lit <br /> �gn�ion because we ha to,t tell ^�n no *o� <br /> of compliance. our ignorance or the low and the DHS feilvre b�us in �� <br /> excuses us. The implication at the meeting was that Medicaid will pleased <br /> a=e us get into complianon with the October 1 signing as the first step. not <br /> The agreement clearly states we will agree to make "reasonable effort, �� <br /> inconsistent onn1mtent wlth other state �l rugulotiona'- to collect ���s from n� r <br /> or Feder i 3 <br /> services". This relatively third-party payors for moc n ' zy innocent clause throws <br /> us into a patient accounts, billing system, clerical shortage and patient health u <br /> records difficulty of significant size. The problem is further complicated by� ' <br /> federal law which makes it illegal to charge Medicaid or Medicare unless everyone <br /> � <br /> � <br /> is charged for that service. <br /> | <br /> ` <br /> ` . <br /> c ' - <br /> � <br /> � <br /> / ` _ <br />