Agenda - 09-22-1980 - Laserfiche WebLink

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a 1 A Hoard of Health Memo re Fee System 4 September ' 9. other--5 persons felt the sliding scale should go down to _ zero; 1 person felt we should only charge neW patients in the maternal clinic; 2 persons were opposed to charging for certain services to some age groups, such as children under 7, teens, or the elderly. One person dial not think we should charge for a health edu- cation service (Teen Parenting). This department and the number of its different activities is overly complex_ I believe that computerization is the proper course to take to handle the data flow_ A fee-for-service system expansion could cause our manual System to collapse. Therefore, I and Lisa Beralzheimer met with Sam Gattis, heal Evans, Johnny Horner, Keith Brooks, et. al., on September 3.. It was concluded that from the stand- points of finance, programer time and our having accomplished the preliminary work, that we should be the next task for the computer center. BOARD DECISION OPTIONS 1. Signing of Medicaid Contract: A. If no--forfeit all Title XIX revenues, EPSDT and Family Planning Grants; B. If yes-- a) Continue Dental and Family Planning fees and not bill. EPSDT or other clinical services to anyone including Medicaid; h) Continue Dental and Family Planning fees as at present, charge: a slld- ing fee scale for all child health services like EPSDT; c) Continue Dental and Family Planning fees, develop a fee scale for EPSDT type child health services, and develop a fee scale for all clinical services that are third-party reimbursable (must have prey, ssnting symptom, be physician supervised acid diagnostic, therapeutic, rehabilitative and/or palliative in nature): d) Continue Dental and Family Planning fees and develop a fee scale for all clinical services. e) Develop, as in Mental Health, a comprehensive fee system for all depart- mental services. DIRECTOR'S RECOMMENDATIONS A. Charge fees for all clinic personal health services except childhood immuni- zations. This excludes community, home based and school personal health services and Health educational services. B. Base the 10090'' fee charge an cost analysis and use of the Medicaid/Medicare reimbursement rates which would constitute the lowest 100% charge. Our costs would be calculated to exclude State furnished materials, Biologics and services. A few procedure charges should be a flat fee. C. Use.our existing fee scale to reduce the 1001 fee by family size and income.. As in Family Planning and Dental, to keep the lower limit at 150' or one dollar, whichever is greater (unless the patient/service is exempted as for teens in Family Planning). The one dollar minimum is also the Medicaid co-payment. --See attached fe- scale and charges examples-- The fees thus generated would constitute about. 2-3% of our budget, (perhapu $15,090). 1 base this prediction on what happened in Dental and Family Planning. 1)cnt.al is a particularly good case study. The fees did not. decrease patient dentanr. fees did document our dental case load in the lowest, income segment; because up to