BACKGROUND: Public sexually transmitted disease (STD) clinics faced with decreased tax revenue and increased costs must evaluate alternative revenue sources. GOAL: To report one public STD clinic's Medicaid-linked revenue and discuss the association between system characteristics and reimbursement potential. DESIGN: This was a cross-sectional study of 4208 patients visiting the clinic for new problems during a 6-month period. RESULTS: Of 458 Medicaid-enrolled patients, only 55% acknowledged enrollment at the time of visit. The clinic captured revenue for many of the remaining 45% through a centralized public health information/billing system, which submitted retroactive STD clinic claims when patients self-reported Medicaid enrollment at later visits to other public health clinics. These belated self-reports also contributed to Medicaid administrative-match reimbursements. CONCLUSIONS: An estimated $100,000 (31% of the clinic's direct reimbursements for service) would have been lost in 2000, had detection of Medicaid enrollment been based exclusively on patients' self-reports at STD clinic visits.
BACKGROUND: Public sexually transmitted disease (STD) clinics faced with decreased tax revenue and increased costs must evaluate alternative revenue sources. GOAL: To report one public STD clinic's Medicaid-linked revenue and discuss the association between system characteristics and reimbursement potential. DESIGN: This was a cross-sectional study of 4208 patients visiting the clinic for new problems during a 6-month period. RESULTS: Of 458 Medicaid-enrolled patients, only 55% acknowledged enrollment at the time of visit. The clinic captured revenue for many of the remaining 45% through a centralized public health information/billing system, which submitted retroactive STD clinic claims when patients self-reported Medicaid enrollment at later visits to other public health clinics. These belated self-reports also contributed to Medicaid administrative-match reimbursements. CONCLUSIONS: An estimated $100,000 (31% of the clinic's direct reimbursements for service) would have been lost in 2000, had detection of Medicaid enrollment been based exclusively on patients' self-reports at STD clinic visits.