Policies and Procedures
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1 BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC. Health Services Policies and Procedures Policy Subject/Title: County Indigent Health Care Programs Applicability: All Sites Accepting County Indigent Health Care Programs as a Payor Source Purpose: To provide access to medical care for those unable to access these services as a direct result of their personal financial resources. Policy: It is the policy of Health Services to participate in payor sources programs that will increase access to health care for the medically underserved in the counties that we serve. Procedure: 1) All patients interested in applying for the County Indigent Health Care Program or qualified under the County Indigent Health Care Program may be found eligible for a sliding fee scale payor code in case their eligibility for the County Indigent Health Care Program is lost. 2) When a patient has unmet need in the area of financial resources the patient will be given a copy of the information from and encouraged to access these resources. 3) To be eligible to receive County Indigent Health Care each patient must complete an application and be approved for the County Indigent Health Care Program in their county by submitting their application to the Brazos Valley Council of Governments offices at P. O. Drawer 4128, Bryan, Texas ) The Brazos Valley Council of Governments, County Indigent Health Care Program will notify applicants when they are approved for services and what provider(s) of medical services has been assigned to them. 5) Per the County Indigent Health Care Program, if a patient becomes ill and requires services prior to them being approved for the program they may obtain emergency medical services at St. Joseph Hospital in Bryan, Texas. 6) A payor code for the County Indigent Health Care Program in each county will be set up in the HealthPro system (see attachment).
2 Page 2 P&P: County Indigent Health Care Programs 7) When a patient registers/calls for an appointment their coverage through the County Indigent Health Care Program will need to be verified and documented in the medical record and the electronic system. A. Verify County Indigent Health Care Program coverage by calling OUTLIERS: 1) There is no presumed eligibility. 2) If a patient registers/makes an appointment and informs us that they are approved through the County Indigent Health Care Program obtain a telephone number where the patient can be reached and inform the patient that we will verify their coverage. If we are unable to verify their coverage the patient will be informed by telephone prior to their appointment. They may keep their appointment and pay according to sliding fee scale rates if they have been found eligible for sliding fee scale. ENCLOSURES: Verification form for County Indigent Health Care Funds Webpage for Information on the County Indigent Health Care Programs: Brazos Valley s Payor Codes Referral Process for County Indigent Health Care Program Participants Covered Services By The County Indigent Health Care Program
3 Brazos Valley s Bryan College Station Grimes County Madison County 813 S. State Street, Ste. 105 Madisonville, TX Phone: Robertson County 1002 West Brown Street Hearne, TX Phone: Leon County 607 Lassater Centerville, TX Phone: S Texas Avenue Bryan, Texas Phone: Dove Crossing Navasota, TX Phone: VERIFICATION OF CURRENT ELIGIBILITY FOR COUNTY INDIGENT HEALTH CARE FUNDS PATIENT S NAME: CLINIC SITE: Date and Time of Appointment: Date of Verification: I called the County Indigent Health Care Program at and spoke with Name of BVCOG Staff Person to confirm CURRENT eligibility for payment of services under the County Indigent Health Care Program. Patient is currently eligible for services. Confirmed termination date of coverage is. (Date) Staff Signature Date
4 PAYOR CODES FOR COUNTY INDIGENT INSURANCE PROGRAM Claims to be sent to: Brazos Valley Council of Governments P.O. Drawer 4128 Bryan, Texas Telephone Numbers: County Indigent Health Care Program: County Indigent Health Care Program FAX: ATTENTION: County Indigent Health Care Program - CLAIMS PAYOR CODE SITE 37 Brazos County Indigent HQ Robertson County Indigent LQ Leon County Indigent MQ Madison County Indigent NQ Grimes County Indigent
5 REFERRAL PROCESS FOR COUNTY INDIGENT HEALTH CARE PROGRAM PARTICIPANTS When a referral is made for a County Indigent Health Care Program participant by a Brazos Valley s provider a copy of the referral will be faxed to the County Indigent Health Care Program at
6 COVERED SERVICES BY THE COUNTY INDIGENT HEALTH CARE PROGRAM BASIC HEALTH CARE SERVICES ARE: Physician services Annual physical examinations, including mammograms by referral Immunizations Medical Screening, i.e. blood pressure, blood sugar, cholesterol screening Lab and x-ray services Family planning services Skilled nursing facility services Prescription drugs Rural health clinic services Inpatient hospital services Outpatient hospital services In addition to the above Basic Services the following services may be reimbursable under the program that would be applicable to : Advanced practice nurse services (NP, CNS, CNM, CRNA) Colostomy medical supplies & equipment Dental Care Diabetic medical supplies & equipment Durable Medical Equipment Emergency medical services Home and community health care services Physician Assistant services FQHC services Specific Exclusions That May Pertain to Services: Treatment of flat foot (flexible pes planus) that is solely cosmetic in nature. ALL SERVICES OR SUPPLIES MUST BE REASONABLE AND MEDICALLY NECESSARY FOR DIAGNOSIS AND TREATMENT.
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