The Local Health Department (LHD) Billing Manual (Manual) provides a framework for LHDs to implement and/or expand their billing infrastructure for healthcare services provided to Maryland residents. Maryland 24 LHDs continue to assess and improve their capabilities for successfully interpreting and adhering to insurance healthcare payment guidelines. This Manual will serve as a technical resource that LHDs will leverage for implementing and/or expanding their medical billing infrastructure.  Sections of the Manual will be updated monthly.​