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ORANGE COUNTY HEALTH DEPARTMENT <br /> Board of Health Policy and Procedures Manual <br /> Section I: Board Adopted Policies <br /> Policy B: Fee and Eligibility Policy <br /> Reviewed by: Financial Review Committee,Health Director <br /> Approved by: Board of Health,Health Director <br /> K. Based on G.S. 130A-41,the Health Director is authorized to enter into contracts,which <br /> may include negotiated reimbursement rates. <br /> L. The Health Director may not make exceptions to the Fee Policy except to accommodate <br /> specific situations through the fee waiver process(Attachment Q. <br /> M. Any minimum administrative fee or flat fees shall be applied without discrimination to all <br /> patients. <br /> N. 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 /> O. Fees for 340b drugs dispensed to Medicaid patients will be reviewed and set annually <br /> based on the average,annual cost to the County to purchase the drugs. <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 /> 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 /> 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 /> 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 /> E. After charges are processed,the client will be given a statement showing the cost of <br /> services for that visit as well as their total account balance upon request. <br /> F. Payment is due at the time services are rendered. <br /> Page 6 of 8 <br /> Original Effective Date:January 25,2001 <br /> Revision Dates:, 4/2016,9/2018,10/2019,10/2020 <br />