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> Resources > Third-Party Billing Guide
Publication

Third-Party Billing Guide

With partners, we developed a resource to support the sustained delivery of STD services in the face of a changing funding and policy landscape. This guide seeks to meet the needs of a range of providers, serving not as a technical manual, but rather an introduction to what providers need to consider as they approach the decisions surrounding third-party billing.

Resource
  1. Third Party Billing guide pdf
Topics
Billing, Laboratories, Providers

The National Coalition of STD Directors (NCSD) has collaborated with key partners to develop a resource to support the sustained delivery of STD services in the face of a changing funding and policy landscape. This guide seeks to meet the needs of a range of providers, serving not as a technical manual, but rather an introduction to what providers need to consider as they approach the decisions surrounding third-party billing.

This guide includes:

  • Overview of the policy and funding landscape
    impacting the decision-making around billing third party
    payers, including provisions in the Affordable
    Care Act that will expand insurance coverage
    through Medicaid expansion and the development
    of state-based insurance exchanges.
  • Analysis of state and local statutory and regulatory
    obstacles which may impede billing a third party
    for STD-related services and recommendations for
    possible solutions.
  • Four case studies highlighting the experiences
    of STD programs and clinics that are currently
    billing third-party payers for STD-related services,
    or are in the process of laying the groundwork
    or developing a plan to implement a third-party
    billing practice. These case studies offer real world
    examples of partnerships and business models for
    building relationships with third-party payers.
  • Sample superbill (encounter form) illustrating
    a representative selection of International
    Classification of Diseases (ICD) diagnostic codes
    and Current Procedural Terminology (CPT) codes
    used to describe medical procedures to help
    familiarize you with the way that STD-related
    services are translated into the language spoken
    with third-party payers. This section also includes a
    brief orientation to the forthcoming shift from ICD-
    9 codes to ICD-10 codes in 2014 in a coding primer.
  • Third-party billing terminology reference sheet
    with definition of commonly used terms.
  • Throughout the guide we ask questions designed
    to help you draw connection back to your own
    context and support you as you map out next steps.

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