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ORANGE COUNTY HEALTH DEPARTMENT <br />Board of Health Policy and Procedures Manual <br />Section I: Board Adopted Policies <br />Policy E: Fee and Eligibility Policy <br />Reviewed by: Financial Review Committee, Health Director <br />Approved by: Board of Health, Health Director <br /> <br /> <br /> Page 6 of 13 <br />Original Effective Date: January 25, 2001 <br />Revision Dates: 6/28/01; 2/26/04; 11/16/06; 10/24/07; 3/26/09, 3/23/12, 10/15/12, 2/4/13, 8/12/13, 10/22/14, 9/22/15 <br />S:\MANAGERS WORKING FILES\BOH\Policies and Procedures\BOH Policy Manual\2014 BOH P&P Review <br /> <br />d. Environmental Health equipment, labor, and staff costs <br />e. Review of fee schedules of surrounding jurisdictions <br />f. Analysis of existing self-pay client base and how increased costs would affect <br />their ability to get necessary care <br /> <br />L. Based on G.S. 130A-41, the Health Director is authorized to enter into contracts, which <br />may include negotiated reimbursement rates. <br /> <br />M. The Health Director may not make exceptions to the Fee Policy except to accommodate <br />specific situations through the fee waiver process (Attachment C). <br /> <br />N. Any minimum administrative fee or flat fees shall be applied without discrimination to all <br />patients. <br /> <br />O. There will be no “schedule of donations”, bills for donations, or any other implied <br />coercion for donations from clients as a condition for being seen at the Health <br />Department. Donations to the health department can be made through the Orange County <br />Community Giving Fund. Fees for services will not be waived because of client <br />donations. <br /> <br /> <br />VII. Fee Collection <br />A. Environmental Health service fees are paid before an appointment is scheduled. Field <br />staff cannot accept fees in the field. <br /> <br />B. Fees collected from Medicaid and Medicare and other third party insurance for a covered <br />service, combined with payment of any applicable co-pays and co-insurance, constitutes <br />full payment for that service. <br /> <br />C. A co-payment, deductible, or balance of charge can be collected at the time of service <br />from individuals covered by other third party insurance plans when OCHD is a member <br />of their provider panel (exception family planning). For Family Planning clients, family <br />income should be assessed before determining whether co-payments or additional fees <br />are charged; if their family income is verified to be at or below 250% FPL, they should <br />not pay more (in copayments or additional fees) than what they would otherwise pay <br />when the schedule of discounts is applied. With regard to other insured clients, payments <br />towards a deductible for clients whose family income is verified to be at or below 250% <br />FPL should have the appropriate sliding fee schedule applied. <br /> <br />D. If OCHD is not on the insurance provider panel, the client will be charged for the <br />service(s) based on the Health Department’s fee schedule. The client will be provided <br />with documentation of services for submission of a claim to their insurance company. <br /> <br />Formatted: List Paragraph, No bullets or <br />numbering <br />Formatted: Indent: Left: 0.75", No bullets or <br />numbering <br />Formatted: Outline numbered + Level: 1 + <br />Numbering Style: I, II, III, … + Start at: 1 + <br />Alignment: Left + Aligned at: 0" + Tab after: <br />0.5" + Indent at: 0.5"