Explanation
BACKGROUND: The purpose of this ordinance is to authorize the Board of Health to enter into a revenue agreement with Medical Mutual of Ohio that will allow the Board to provide and be paid for covered medical services that are provided to clients who have insurance coverage under Medical Mutual of Ohio. This agreement will make Columbus Public Health an in-network provider and facilitate billing and reimbursement for all parties involved.
All the clinics at Columbus Public Health will be a participating provider in the PPO, HMO, POS and Workers’ Compensation products of Medical Mutual and will be listed in the network directory maintained by Medical Mutual.
FISCAL IMPACT: As an in-network provider, the Board will be reimbursed for covered services the lesser of the Board’s fee or the Network Fee Schedule in effect at the time services are rendered, minus the sum of the Client’s (Covered Person’s) obligations.
These monies will be deposited into the appropriate Health Department Fund based on the clinic that provides the reimbursable services. Because this is just a new process and not a new revenue source, the monies are already included in Health’s Revenue Estimates and, as such, are already appropriated to the Health Department.
Title
To authorize the Board of Health to enter into revenue contract with Medical Mutual of Ohio to become an in-network provider for reimbursement for services provided to eligible clients at Columbus Public Health’s clinics.
Body
WHEREAS, the Board has been providing medical services to clients with insurance coverage from Medical Mutual of Ohio; and,
WHEREAS, the Board desires for all of the clinics at Columbus Public Health to become in-network providers with Medical Mutual of Ohio in order to facilitate billing and reimbursement for all parties involved; and,
WHEREAS, in order for Columbus Public Health to become an in-network provider, it is necessary to enter into a revenue agreement with Med...
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