Strategies for AIDS Service Organizations (ASOs) and Community Based Organizations (CBOs) to respond to changes in the health care delivery and financing environment.
Contracting
Collection of resources on contracting with health insurance plans and provider networks, with an emphasis on leveraging the agency's role as an Essential Community Provider (ECP). Marketplace plans must include some ECPs in their provider networks.
Resources 11
Webinars and Training
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Primary Care Development Corporation (PCDC)February 2020
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Primary Care Development Corporation (PCDC)July 2019
Learning module series on billing, for Ryan White-funded Community Based Organizations (CBOs) and AIDS Services Organization (ASOs).
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HealthHIVMay 2016
Training resources on enhancing billing systems to maximize revenues, covering CPT and ICD codes in the HIV/AIDS care context.
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CRE TA CenterApril 2016
Tips for negotiating contracts with insurers.
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CRE TA Center, National Center for Innovation in HIV CareNovember 2015
Review of the basics of Medicaid contracting with a focus on Medicaid Managed Care Organizations (MCOs).
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CRE TA CenterOctober 2015
Review of contracting opportunities (e.g., marketing when negotiating contracts) for Ryan White funded agencies that provide medical care and other services.
Tools and Job Aids
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CRE TA CenterMay 2017
Tips for Ryan White HIV/AIDS Program recipients and sub-recipients on ways to improve contracting and billing processes.
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CRE TA CenterMarch 2016
This is a tool for conducting a cost analysis. It outlines the process of determining the unit cost, or the average cost, of providing specific services. This is calculated over a defined period of time. This allows the information to be used to bill and secure reimbursement for services provided.
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CRE TA CenterJanuary 2016
Actions agencies can undertake to expand or establish contracts with Medicaid or Marketplace Insurance Plans.
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CRE TA CenterSeptember 2015
Tool for assessing organization regarding areas of importance to insurers and that support maximizing revenue from contracting activities.
Reports and Best Practices
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Primary Care Development Corporation (PCDC)May 2018
Results of needs assessment to guide the development of training and technical assistance services to help ASOs and CBOs increase their capacity to provide direct HIV care and treatment.