B-Notification follow-up using an assigned position (outreach worker)

What it is:

Outreach workers who are non-clinical (Health Workers and Disease Control Investigators) are assigned B notifications to follow-up on.  Assignments are made based on similar language and culture.  The follow-up is done using an established protocol and includes phone calls, letters and home visits.

Why this is a best practice:

Saves resources and prevents clinic scheduling conflicts by using non-clinical staff  (nurse or other high level clinical staff).  Also, this has proven successful in getting patients with B notifications to come to TB Clinic for evaluation and, if needed, treatment.  In addition, there is more likelihood to be able to match on language and culture with using non-clinical staff, rather than RNs or PHNs.

Resources required (staff, time, tools):

Outreach worker – each follow-up attempt takes about 15 minutes.  Tools include a protocol/flow chart and letter template.  The letter is available in most languages of B-notification patients.  Other resources include a database system to track follow-up attempts and outcomes.

Protocols, forms, tools, templates, documents available?

Insurance billing for TB services through cross-trained staff

What it is:

Cross training of staff to assess for eligibility and to complete billing encounter forms.  Clerical staff is trained in eligibility and they determine patients’ eligibility for Medi-Cal or other insurance program.  Initial step is assessment of eligibility of new patients through clerical staff at first visit.  If eligible, clerical staff enrolls them and billing clerks bill for all services.  All TB Control staff (clinical and non-clinical) are trained on billable services and steps to complete billing encounter forms.  These completed forms are then passed to billing clerks for submission for reimbursement.  Hospital eligibility worker/Administrative Supervisor provides technical assistance and oversees the process. 

Why this is a best practice:

This practice saves county general fund resources for use with those not eligible for Medi-Ca or other insurance, and allows TB Control to generate more revenue.  Through process of cross training staff on eligibility and/or completing billing encounter forms we maximize opportunities for appropriate and accurate billing.

Resources required (staff, time, tools):

* Staff to work as eligibility workers

* Staff to complete billing encounter forms for every encounter, and the billing system encounter forms (usually county-generated forms) 

Protocols, forms, tools, templates, documents available?:

Billing system and encounter forms used in San Francisco TB Control are generated by the county; we assume other counties have these as well.

Contact information for best practice:

Jennifer Grinsdale, TB Control Program Manager
415-206-6101
jennifer.grinsdale@sfdph.org

OR

Fay Hui, Hospital Eligiblity Worker and Administrative Supervisor
415-206-6941
fay.hui@sfdph.org

San Francisco General Hospital, TB Control Section
1001 Potrero Avenue, Ward 94
San Francisco, CA  94110