Billing and Collections

In this section:

Primary Reviewer: Fiscal Expert

Secondary Reviewer: Governance/Administrative Expert (as needed)

Authority: Section 330(k)(3)(E), (F), and (G) of the Public Health Service (PHS) Act; and 42 CFR 51c.303(e), (f), and (g) and 42 CFR 56.303(e), (f), and (g)

Health Center Program Compliance Manual Related Considerations

Documents the Health Center Provides

Compliance Assessment

Select each element below for the corresponding text of the element, site visit team methodology, and site visit finding questions.

Footnotes

1. For information on Federal Tort Claims Act (FTCA) coverage in cases where health centers are using alternate billing arrangements in which the covered provider is billing directly for services provided to covered entity patients, refer to the FTCA Health Center Policy Manual (PDF - 406 KB), Section I: E. Eligibility and Coverage, Coverage Under Alternate Billing Arrangements.

2. This includes services that the health center provides directly (Form 5A: Services Provided, Column I) or provides through a formal written contract/agreement (Form 5A: Services Provided, Column II).

3. See [Health Center Program Compliance Manual] Chapter 9: Sliding Fee Discount Program for more information on the SFDS.

4. These items differ from supplies and equipment that are included in a service as part of prevailing standards of care and are reflected in the fee schedule (for example, casting materials, bandages).

5. See [Health Center Program Compliance Manual] Chapter 15: Financial Management and Accounting Systems for related information on revenue generated from such charges.

Date Last Reviewed: