Training & Consulting Solutions for FQHC Billing & Coding

Federally Qualified Health Centers (FQHCs) have been the backbone of the healthcare provider system in the United States for almost 50 years. Initially called Neighborhood Health Centers, FQHCs treated nearly 22 million patients in 2012 alone. Even more, they are there to provide health care services to our nation’s neediest population. An average FQHC is always a nonprofit organization. It also has an independent governing board of directors. fqhc billing

With that said, FQHCs provide health and medical treatment to an underserved area or population, providing comprehensive services and offering a sliding fee scale. Sliding fee scale is required as it offers discounts based on patient’s family size and income in accordance with federal poverty guidelines. Health centers must be open to all, regardless of their ability to pay.

However, many patients are unable to pay for their care services even at their discounted rates. Due to this, there are challenges FQHCs experience collecting payments at the time of service. It’s essential for all FQHCs to maximize insurance billing revenue and implement collection procedures properly.

Issues Surrounding FQHC Billing

The average health center has an insurance billing and collection rate of around 70%. Slide patients and self-pay patients are not included. As FQHC is tailored with many components, sometimes it’s quite challenging to identify breakdowns and bad chains in the FQHC billing process.

There are several causes of lost revenue. In many cases, these causes are outlined below.

  • Failure to obtain current patient information
  • Failure to collect on previous patient account balances
  • Failure to collect co-payments and minimum fees
  • Not filing claims timely
  • Not working denials timely
  • Physicians not recording all services performed during the office visit
  • Failure to redirect claims properly

In order to maximize medical billing revenue streams, FQHC billing systems should require:

  • An adequate and competitive fee schedule
  • Timely follow-up on all uncollected amounts
  • A corresponding schedule of discounts
  • Billing of patients in accordance with the schedule of discounts

Even more, in order to maximize revenue, there need to be some consequences. Past balances cannot be ignored. If needed, attorney and collection agency should be invited. That’s because there’s a misconception that FQHCs are free clinics. Providing health services to the underserved community requires dedication, staff, resources and budget. While federal programs help offset certain costs, FQHCs are expected to pay their fair share based on their ability to pay.

Professional FQHC Billing Services & Training

Since the revenue stream in an FQHC center is the lifeblood that keeps the center active, it often makes sense to consult industry experts. Below are discussed top 3 billing training providers.

Practice Management

Practice Management offers the much needed experience and resources to improve FQHC billing systems. They are well-versed in providing a wide range of medical billing services, with expertise in FQHC billing services. Practice Management is reputable medical billing company with a proven track record in maximizing revenue as well as decreasing collection turn-around time.

Visualutions

Visualutions is a well-established company that wants to help your health center prepare and train for billing collections. You need to provide them with a few details so they can assist you in coordinating the training to your system. As their name implies, they are interested in solutions.

Synergy Billing

Synergy Billing is the industry’s leading FQHC billing company with the best collection rates. As the FQHC billing process is sometimes complicated, community health centers face a number of billing challenges. Synergy Billing has lots of experience in helping community health centers maximize their FQHC billing revenue. They believe there are effective ways to collect every dollar for your health center.