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Web Training Area

Clinics

Overview

Hospital-Based Outpatient Clinics

A hospital-based outpatient clinic (HBOC) is defined as a clinic providing “outpatient service” as listed on the hospital’s general acute-care license issued by the State Department of Public Health.

The HBOC is a setting in which integrated and accessible primary and specialty health care services are provided by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustainable partnership with patients, and practicing in the context of family and community.

A hospital-based outpatient clinic (HBOC) is defined as a clinic providing “outpatient service” as listed on the hospital’s general acute-care license issued by the State Department of Public Health.

The HBOC is a setting in which integrated and accessible primary and specialty health care services are provided by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustainable partnership with patients, and practicing in the context of family and community.

The clinic may be located on or off the main grounds of its hospital, but must be owned and operated by a hospital or system. The clinic must be formally organized as a Federally Qualified Health Center (FQHC) [county owned and operated], Federally Qualified Health Center Look-Alike (FQHC-LA) [county owned and operated], Rural Health Clinic (RHC), Outpatient Primary Clinic or Specialty Care Clinic. It must be primarily engaged in providing outpatient health services that furnish diagnostic and therapeutic care. This includes medical history, physical examinations, assessment of health status and treatment monitoring for a variety of medical, dental or behavioral health conditions.

This definition does not include clinics exclusively designed for and providing laboratory, X-ray, testing, therapy, pharmacy or educational services.

 

Overview

California’s Clinic World

A clinic is a health care delivery setting primarily engaged in providing outpatient health care furnishing diagnostic and therapeutic services. This includes medical history, physical examination, assessment of health status and treatment for a variety of medical, dental or behavioral health conditions. Care provided in this setting is often referred to as “primary care.”

A clinic is a health care delivery setting primarily engaged in providing outpatient health care furnishing diagnostic and therapeutic services. This includes medical history, physical examination, assessment of health status and treatment for a variety of medical, dental or behavioral health conditions. Care provided in this setting is often referred to as “primary care.”

There are a number of clinics in California that provide primary care services. These clinics are identified in a number of ways based on how they are licensed by the state and whether or not they are federally certified.

A hospital-based outpatient clinic (HBOC) is defined as a clinic providing “outpatient service” as listed on the hospital’s general acute-care license issued by the State Department of Public Health. The HBOC is a setting in which integrated and accessible primary and specialty health care services are provided by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustainable partnership with patients, and practicing in the context of family and community.

The clinic may be located on or off the main grounds of its hospital, but must be owned and operated by a hospital or system. The clinic must be formally organized as a Federally Qualified Health Center (FQHC) [county owned and operated], Federally Qualified Health Center Look-Alike (FQHC-LA) [county owned and operated], Rural Health Clinic (RHC), Outpatient Primary Clinic or Specialty Care Clinic. It must be primarily engaged in providing outpatient health services that furnish diagnostic and therapeutic care. This includes medical history, physical examinations, assessment of health status and treatment monitoring for a variety of medical, dental or behavioral health conditions.

This definition does not include clinics exclusively designed for and providing laboratory, X-ray, testing, therapy, pharmacy or educational services.

The attached provides a visual depiction of California’s clinic world from a Rural Health Clinic perspective.

CHA News Article

CDPH Issues AFL on Primary Care Clinic Consolidated Licensure

BJ Bartleson, RN, MS, NEA-BC Debby Rogers, RN, MS, FAEN

The California Department of Public Health  has released the attached All-Facilities Letter outlining compliance requirements for licensed primary care clinics (PCCs) under AB 2053 (Chapter 639, Statutes of 2016), which took effect Jan. 1. AB 2053 established consolidated licensure for PCCs, allowing eligible clinics to add additional physical plants to their current license maintained and operated on separate premises. A PCC or affiliate clinic may add additional locations that are no more than one-half mile from the licensed clinic adding the additional physical plant. A licensing fee is required for each additional physical plant approved on the license. For more information, see the attached letter.

CHA News Article

FAQs Available on Reporting Requirements for Rural Health Clinics

Alyssa Keefe

The Centers for Medicare & Medicaid Services (CMS) has released a frequently asked questions document addressing recent changes to billing for rural health clinics. As previously reported in CHA News, effective April 1, rural health clinics were required to report the appropriate HCPCS code for each service line, along with the revenue code and other required billing codes. This change was mandated by the calendar year 2016 physician fee schedule final rule. The attached FAQ addresses questions related to modifier CG, as well as modifiers 25 and 59. Facilities are reminded that charges greater than or equal to $0.01 should be reported with the appropriate HCPCS code. More information about rural health clinic payment and policies is available on the CMS website.

CHA News Article

AHRQ Releases Playbook on Integrating Behavioral Health Care in Ambulatory Settings

Sheree Lowe

The Agency for Healthcare Research and Quality (AHRQ) has released a new guide to integrating behavioral health in primary care and other ambulatory care settings. The free guide provides tips, resources, and real-world examples of how practices are integrating behavioral health care; pitfalls to avoid; an interactive self-assessment checklist; and access to an online forum for peer-to-peer networking and sharing. While the focus is on primary care, ideas presented “can easily translate to medical specialties such as neurology, oncology, or occupational medicine,” AHRQ notes.

Recording

Hospital Presumptive Eligibility Program Webinar
A vital tool for providing potentially-eligible individuals with on-the-spot Medi-Cal coverage

Webinar Recorded Live on June 19, 2014

Hospitals can play an important role in reducing the number of uninsured through the Hospital Presumptive Eligibility (HPE) program. The HPE program will allow all hospital Medi-Cal providers — including any clinic on a hospital’s license — to provide potentially-eligible individuals with temporary, full-scope Medi-Cal benefits.

Commands