NHSC compliance

[randomdoc1]

Has anyone had experience with this? I've been applying for various loan forgiveness programs for the clinic to qualify for. One of them is to become an NHSC approved site. I'm asking our state primary care office as well, but definitely worth double checking to make sure I am in compliance. Now, some areas that are softer calls that make me think a little include but are not limited to the following

-it calls for sites to be able to offer a wide variety of care to a multitude of disorders. The language can be vague. For example, what if someone presents with a more specialized area of focus such as severe OCD or opiate use disorder? What have your experiences been with say, providing outside referrals (to in network providers of course) or does it get considered as a disqualification if you refer out. I'd think in certain cases, it's better to provide a sub-specialist or higher level of care if your office does not have it.

-after hours coverage. I wonder if the NHSC program would accept referral to a separate entity, we have a 24/7 psychiatric ER nearby that is an NHSC approved site. So patients can always go there after hours or call. Or is NHSC requiring providing of in house on call services?

-it also requires us to put up signage prominently that states no one will be denied care based on inability to pay and that there is a sliding scale program available. I'm concerned this exact phrasing can be misinterpreted by some patients as a blanket statement and people in general will just start asking for free care or very low rates. So has anyone had experience with NHSC and providing more clarity in that phrasing such as, emphasizing we will continue to help patients access care and that the sliding scale fee is assessed carefully based on federal poverty guidelines? That sounds like a more balanced way of presenting it while providing some healthy distance from the slippery slope of financial dispute with a patient.

Any words are appreciated!

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[alina_s]

My first job was a NHSC scholar site and our after hours coverage was a not-so-helpful state-run system. None of us worked in it. I think they had case workers who helped people get Medicaid and don’t think there were many people with either private insurance or sliding scale. I was blessedly free of any responsibilities around billing, though.
I also interviewed at CMHC site that got approved as a NHSC a site remarkably fast.
My current employer is approved for the NHSC and our call system is the local ER, whom we share records with but aren’t the same corporation. We do have a sliding scale, but most are Medicaid or IHS.

 

[randomdoc1]

My first job was a NHSC scholar site and our after hours coverage was a not-so-helpful state-run system. None of us worked in it. I think they had case workers who helped people get Medicaid and don’t think there were many people with either private insurance or sliding scale. I was blessedly free of any responsibilities around billing, though.
I also interviewed at CMHC site that got approved as a NHSC a site remarkably fast.
My current employer is approved for the NHSC and our call system is the local ER, whom we share records with but aren’t the same corporation. We do have a sliding scale, but most are Medicaid or IHS.

Yes, that's what I thought too! If their income is so low, they'd likely qualify for Medicaid. I guess the trick is the patients getting on to Medicaid as we don't have caseworkers. I've been gathering some ideas and I do see NHSC sites having an application for people to fill out and documents to provide. So that way there is a means to objectively assess a patient's means or it can easily become a slippery invitation.