Social Networks and Best Practices in Public Health: The Example of Regional Billing Groups
Article first published online: 7 NOV 2006
Public Health Nursing
Volume 23, Issue 6, pages 541–546, November/December 2006
How to Cite
Whitmer, D. A., Hawley, S. R., Orr, S. A., Romain, T. St. and Molgaard, C. A. (2006), Social Networks and Best Practices in Public Health: The Example of Regional Billing Groups. Public Health Nursing, 23: 541–546. doi: 10.1111/j.1525-1446.2006.00594.x
- Issue published online: 7 NOV 2006
- Article first published online: 7 NOV 2006
- health care finance;
- rural health;
- social support
ABSTRACT Objective: Rising health care costs, increased demand for clinical services, and reimbursement difficulties created a funding shortage among local health departments in the state of Kansas. This intervention established regional billing groups to provide professional support and increase third-party reimbursement.
Design: Through feedback sessions, billing clerks provided qualitative responses about training needs. These informed the process of establishing billing groups in each state health district.
Sample: All billing clerks in the state's 6 regional health districts were invited to participate, as were insurance and billing software representatives.
Intervention: Between April 2002 and September 2004, 6 collaborative groups were established. Billing clerks received professional support and training from peers, insurance representatives, and software providers. An interagency billing advisory team was established to coordinate training activities between groups.
Results: These groups have allowed local health departments to increase reimbursement revenue by 50%–75%, allowing for the provision of expanded health services to client populations.
Conclusions: These methods can serve as a model for other states, particularly those with considerable rural populations or decentralized health care systems. Still, funding shortages persist, and public health billing clerks will continue to need ongoing training in the most current and effective billing methods.