HomeMy WebLinkAbout2011-262 Health - Wake Radiology Diagnostic Imaging, Inc. - Agreement for X-Ray Services for OCHD patients STATE OF NORTH CAROLINA
ORANGE COUNTY
July 1, 2011—June 30,2012
AGREEMENT FOR X-RAY SERVICES FOR ORANGE COUNTY
HEALTH DEPARTMENT (OCHD) PATIENTS
The following are procedures to be used in providing x-ray services to Orange County Health Department
referrals:
1. Wake Radiology Diagnostic Imaging, Inc.will provide a PA chest x-ray and written interpretation for
OCHD referred patients without active TB symptoms.
a. The patient does not need an appointment, but needs to present to Wake Radiology during
regular business hours.
b. The patient must bring a current completed chest x-ray voucher from OCHD.
c. A PA chest x-ray will be taken, developed, and read.
d. A two view chest x-ray if ordered will be taken, developed, and read.
e. A written interpretation of the chest x-ray will be mailed to:
Orange County Health Department
2501 Homestead Road
Chapel Hill, NC 27516
Attn: Sue Rankin, R.N.
f. The x-ray and voucher will be maintained in the office of Wake Radiology.
g. The patient will not be charged for the x-ray. OCHD will be billed at a fee of$62.00 per single
view chest x-ray(71010) and $80.00 for a two view chest x-ray(71020). The bill will be sent
to:
Orange County Health Department
P. O. Box 8181
Hillsborough, NC 27278
Attn: Sue Rankin, R.N.
This agreement is to be in effect from July 1, 2011 through June 30, 2012 and is renewable annually.
7 �
Dorothy Cilenti, Dr H, Interim Health Director Dat
Orange County Health Department
`"7 �;L!be
Roberf E. Schaaf, MD(, President Date
Wake Radiology Diagnostic Imaging, Inc.
Clarence Grier Date
Orange County Finance Director
Orange County Finance Director
"This instrument has been pre-audited in the
manner required by the Local Government
Budget and Fiscal Control Act."