Topic: Program Income
Agencies can fiscally benefit by generating program income through contracts with public and private payers and efficient billing systems.
Guidelines and Manuals
HRSA HIV/AIDS BureauDecember 2016
HRSA's HIV/AIDS Bureau guidance and requrements for grantees of the Ryan White HIV/AIDS Program on such topics as eligibility, allowable use of funds, and clarifications of legislative requirements.
Webinars and Training
HRSA/HAB Fiscal Monitoring Standards require Ryan White HIV/AIDS Program recipients and subrecipients to have policies and procedures regarding the imposition and assessment of client charges.
Training resources on enhancing billing systems to maximize revenues, covering CPT and ICD codes in the HIV/AIDS care context.
HRSA HIV/AIDS BureauMay 2015
Resources and training to assist Ryan White grant recipients in administering their Ryan White HIV/AIDS Program (RWHAP) grants.
National Center for Innovation in HIV CareMay 2015
Webinar on the organizational benefits of developing pharmacy services, the different models of pharmacy that can be utilized at different organizations, and steps required to develop these services.
HRSA HIV/AIDS BureauMarch 2015
Presentation on sliding fee scale and cap of out-of-pocket charges.
Positive Outcomes and The George Washington UniversityMay 2013
Webcast (and slides) on what HIV medical clinics should consider in assessing readiness and preparing for or expanding participation in health insurance markets.
Training on meeting federal and state fiscal requirements, fiscal compliance assessment, implementing Ryan White payer of last resort policies, applying Federal Poverty Level guidelines to assess sliding fees, and financial sustainability.
Tools and Job Aids
Assessment of Medicaid coverage of HIV/AIDS prevention, screening, and care services (e.g., testing, counseling, PrEP, condoms) in ten selected states.
CRE TA CenterMarch 2016
Tool for conducting a cost analysis: the process of determining the unit cost or the average cost of providing specific services over a defined period of time in order to use this information to bill and secure reimbursement for services provided.
CRE TA CenterSeptember 2015
Tool for assessing your organization’s strengths and gaps in areas that are of importance to insurers and that support maximizing revenue realized from contracting activities.
Insights for ADAPs in establishing procedures for seeking rebates when a prescription is filled by another 340B entity (pharmacy), to ensure that either ADAP other the other entity receives the rebate or discount for the claim.
TARGET CenterOctober 2013
Collection of resources on compliance programs, which are an essential component of agency operations and entail mechanisms to ensure, for example, appropriate handling of payments, claims, and audits.
West County Health CentersMarch 2013
Form for clients explaining the maximum annual amount of costs patients will incur (annual payment cap) for services they receive from Ryan White providers. Once this payment cap is reached in a given year, Ryan White providers will not charge any more for the rest of the year.
Resources to build agency skills in financial management (e.g., federal grant requirements, budgeting, fundraising, accounting principles).