Sexually transmitted disease services and third-party payer reimbursement: Attitudes, knowledge, and current practices among 60 health departments/districts. Why does this matter to public health nurses?

OBJECTIVE: To assess staff attitudes, knowledge, and current practices in billing third-party payers for sexually transmitted disease (STD) services in public health departments/districts.

DESIGN AND SAMPLE: A cross-sectional, online survey was administered to staff at 60 urban and rural health departments/districts. Snowball sampling was used for greater representation. There were 311 staff responses from 56 agencies represented in the data analysis. Of the 311 responses, 106 were public health nurses and seven of the health directors had nursing backgrounds.

MEASUREMENT: The survey measured attitudes, knowledge, and current billing practices for STD services. Analysis of data was performed at both individual and agency level.

RESULTS: Almost 90% reported it was acceptable to bill insurance. However, 56% felt these services should remain a "free" service in the agency. Most agencies were billing Medicaid for STD services (95%) and 70% bill private third-party payers.

CONCLUSIONS: Current funding for public STD clinics is not sustainable and other viable income streams such as third-party payer reimbursement must be utilized. Public health nurses play a pivotal role in developing policies and procedures in billing third-party payers for STD and other clinical services. Understanding the interactions between attitudes, knowledge and practice are vital in this development.