Submitted on Thu, 2014-06-26
By Cecelia Jacobson

How a billing program will generate sustainable revenue to fund community health programs, maintain or grow staff, buy new equipment, and expand services.

local health department billing

Staff cuts and limited budgets often lead to local health department employees working on projects that aren’t in their job description. It’s quite common for a busy nurse to also be in charge of the clinic’s billing program. Unfortunately, this means that more time can be spent contacting insurance companies and resubmitting denied claims than taking care of patients. With limited funding and staff, how can you increase revenue from your billing program without straining your staff?


Developing Your Billing Program with a Partner

Luckily, you don’t have to go at it alone. Bringing in a billing partner will help you capture revenue for existing services without overwhelming your staff. Utilizing outside help for your medical billing is easier and cheaper than you think. The revenue from existing services is there for the taking, it’s just a matter of whether or not you want it. With minimal upfront costs and expenses taken as a small percentage out of revenue generated, there is no downside to outsourcing your public health agency’s billing program. The revenue you start bringing in provides a fast ROI, and ongoing costs are tied to revenues brought in. So, no revenue in, no cost out. All you’ll notice is revenue rolling in so that you can maintain or expand your staff and services.

Here are the main areas that a partner can help your billing program:


Insurance Contracting & Credentialing

Contracting and credentialing with insurance companies requires research, time, and highly detailed work that may not currently fit into existing public health agency budgets or skillsets. Bringing in outside help for your billing puts the process in the hands of experts who have already built up relationships with private insurance companies through past experience.

Whereas it may take a local health department a year or more to secure a contract, a third-party expert may be able to secure the same contract in 60-90 days. This will allow you to use your salary costs more effectively and most importantly, your staff can focus on what it does best, improving your community’s health, instead of navigating their way through the endless bureaucracy of an insurance company.


Billing & Claims Processing

Just as with contracting and credentialing, bringing in outside help for your billing program greatly simplifies the claims management process for you. Simply send encounter forms to your billing partner at the frequency of your choosing and you’re done. Your partner will process the claim and perform any and all follow ups with insurance companies to correct rejected claims. This is especially true for local health departments without billing staff, who are missing even more opportunities to bill.


Collecting Revenue

The next step you should see is the revenue floating into your department. After your billing partner has finished with the claim, your health department will receive a check right from the payers.


It’s time for a change. Get a free healthcare revenue performance evaluation from our public health experts today to learn more. Our consultants and SMART Health Claims Management solutions helps local health departments and community health centers generate 35-70% more sustainable revenue within a month. More than 100 departments have signed up for SMART Health Claims Suite so far this year, and every one of them is seeing dramatically increased revenue.

About the Author

public health expert

Cecelia has her degree in Communication Studies and Environmental Science from DePaul University and is working as a Senior Healthcare Industry Analyst for Upp Technology’s Public Health Division. Working closely with a number of health departments to improve clinic work flow, revenue enhancement and technology advancement, Cecelia’s objective is to help local health departments better serve their community and patients. She has volunteered in a number of different settings, including a long term public health initiative with a community in Mexico. You can contact Cecelia at

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