National Council of Urban Indian Health (NCUIH) Paper on Urban Indian Health Program Third-Party Billing Issues 10-02-09
Authors: National Council of Urban Indian Health
Publication Year: 2009
Last Updated: 2010-08-18 14:58:25
Journal: NCUIH
Keywords: uihp, urban indian health program, ta, technical assistance, third-party billing
Short Abstract:
Accessing revenue through Third-Party Billing (Medicaid, Medicare, and third-party Insurance), is historically foreign to many Urban Indian Health Programs (UIHPs) as they were set up under a different federal system that, over time, became a dysfunctional patchwork of assorted programs. Lack of knowledge about the Third-Party Billing (TPB) system as well as negative federal policy towards their existence has severely handicapped the UIHPs ability to improve, expand, and adequately finance their core operations. Navigating a multi-layered, multi-component system can be very overwhelming for UIHPs; especially because the TPB system entails complex technical challenges that can be exacerbated by legal and technological issues (e.g. a situation combining Medicaid services, Federal Qualified Health Center status and Electronic Health Records). Approaching the TPB issue in UIHPs will thus require an interdisciplinary technical assistance program to successfully implement and maximize third party billing in an era of Health Information Technology (HIT).
Abstract:
Accessing revenue through Third-Party Billing (Medicaid, Medicare, and third-party Insurance), is historically foreign to many Urban Indian Health Programs (UIHPs) as they were set up under a different federal system that, over time, became a dysfunctional patchwork of assorted programs. Lack of knowledge about the Third-Party Billing (TPB) system as well as negative federal policy towards their existence has severely handicapped the UIHPs ability to improve, expand, and adequately finance their core operations. Navigating a multi-layered, multi-component system can be very overwhelming for UIHPs; especially because the TPB system entails complex technical challenges that can be exacerbated by legal and technological issues (e.g. a situation combining Medicaid services, Federal Qualified Health Center status and Electronic Health Records). Approaching the TPB issue in UIHPs will thus require an interdisciplinary technical assistance program to successfully implement and maximize third party billing in an era of Health Information Technology (HIT).
Contrary to the general belief, UIHPs are not funded like tribes. Neither are they fully considered as part of the general health care system in the country. Caught in the midst of the political and funding entanglements between the US and the Tribal Governments, the Urban Indian communities (created via forced relocation 50s-60s) and their Health Programs greatly struggle to secure funding. Neither system fully embraces them, thus evolving as orphans from both the Tribal and the US Health Systems.
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