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ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy E: Fee and Eligibility Policy Reviewed by: Financial Review Committee, Health Director Approved by: Board of Health, Health Director Page 11 of 13 Original Effective Date: January 25, 2001 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 S:\MANAGERS WORKING FILES\BOH\Policies and Procedures\BOH Policy Manual\2014 BOH P&P Review O. Any minimum administrative fee or flat fees shall be applied without discrimination to all patients. P. There will be no “schedule of donations”, bills for donations, or any other implied coercion for donations from clients as a condition for being seen at the Health Department. Donations to the health department can be made through the Orange County Community Giving Fund. Fees for services will not be waived because of client donations. IV. Fee Collection A. Environmental Health service fees are paid before an appointment is scheduled. Field staff cannot accept fees in the field. B. Fees collected from Medicaid and Medicare and other third party insurance for a covered service, combined with payment of any applicable co-pays and coinsurance, constitutes full payment for that service. C. A co-payment, deductible, or balance of charge will be collected at the time of service from individuals covered by other third party insurance plans when OCHD is a member of their provider panel (exception family planning). For Family Planning clients, family income should be assessed before determining whether co-payments or additional fees are charged; if their family income is verified to be at or below 250% FPL, they should not pay more (in copayments or additional fees) than what they would otherwise pay when the schedule of discounts is applied. With regard to other insured clients, payments towards a deductible for clients whose family income is verified to be at or below 250% FPL should have the appropriate sliding fee schedule applied. D. If OCHD is not on the insurance provider panel, the client will be charged for the service(s) based on the Health Department’s fee schedule. The client will be provided with documentation of services for submission of a claim to their insurance company. E. At the time services are received, the client will be informed of the cost of services for that visit as well as their total account balance. F. Payment is due at the time services are rendered. G. When the client is unable to pay in full at the time services are rendered, a payment plan is established, and the client must sign a “Payment Agreement Form” (Attachment D) except for minimum-fee or flat-fee charges. H. When a client requests “no mail”, discussion of payment of outstanding debt shall occur at the time the service is rendered. A remark regarding “no mail” is entered into the medical data system. No letters or other correspondence concerning insurance or past due accounts will be sent to any client that requests “no mail”.