Third-Party (or health care) billing is the process of charging public and private insurance/health plans for the purpose of reimbursing services rendered by a healthcare provider. While local health departments (LHDs), community-based organizations (CBOs), and other healthcare providers (HCPs) are some of the most common providers of public health services, many of them have not developed capacity to bill public or private payers/health plans.
Healthcare providers need to maximize revenue capture to sustain their organizations and to continue to provide essential public health services in an era of dwindling public funding. Public health providers often offer safety net coverage: ensuring that low-income clients, many newly insured under the Affordable Care Act (ACA)/expanded Medicaid, have access to public health services.
The Illinois Public Health Association (IPHA) has a long, successful history in assisting local health departments, community-based organizations, and other healthcare providers with implementing the six core components of third-party billing:
- credentialing
- contracting
- coding
- billing
- electronic medical records implementation
- revenue cycle management
IPHA's technical assistance has resulted in the generation of more than $40 million in new revenue for essential public health services in Illinois over the past decade. In 2020, the IPHA Third-Party Billing project was recognized as a Billing Project Success Story by the Centers for Disease Control and Prevention (CDC). CDC funded 38 projects nationwide and only six projects received this recognition. Read IPHA's success story here.
For more information on Healthcare Billing, please contact Phil Talley, Program Manager.
Third-Party Billing Webinar Archive
Third-Party Billing Digest Archive
Page updated April 11, 2024