Federally Qualified Health Centers (FQHCs) are local community health centers that are dedicated to serving the underprivileged. Because of this dedication, they receive grants and qualify for more reimbursement from Medicare and Medicaid. FQHCs differ from regular practices because they must cater to an underserved region or demographic, provide many encompassing services, offer a sliding fee scale, and have a quality assurance program that is ongoing.
Health center employees engaged in FQHC billing need to know that FQHCs can be paid utilizing one of two methods. They can be paid on a prospective payment basis, or they may be paid under an alternative payment method that is approved individual FQHCs.
Awareness and understanding of the basic principles and best practices of FQHC billing (like the latter point about billing methods) is vital to improve the overall collections process for these community health centers. Below we offer more by sharing several effective medical billing and coding tips for FQHCs.
Communicate With Patients Strategically
Medical billing employees can help the staff at the FQHC by clearly posting all of the billing information spelled out clearly and in an obvious location around where the patient checks in. Included in this should be requirements for insurance, upfront payments that are necessary, co-payments and a breakdown of the billing procedure.
When patients come in, collect their demographics and obtain a copy of their insurance card. This will streamline the coding process and allowing you to submit claims more quickly. Bring a policy to the clinic that all patients must show government-issued identification at check-in, then make a copy and keep it in their records.
Use Technology to Maximize Effectiveness
Always use the most up-to-date software for FQHC billing, so that you have the luxury of quickly figuring out if claims will be accepted or denied. There are changes in medical billing rules constantly, and these programs automatically update as the rules regarding FQHC billing change. This will help medical billing staff identify new trends that occur in denials, which can help improve billing for health centers and FQHCs.
Collect Full Patient Information to Increase Billing Efficiency
Take the time to be sure that the patient’s information is both accurate and complete. It is essential to get a patient’s full name, work information, address, and birth date as well as multiple phone numbers.
This is critical when working with insurance companies and as part collection procedures if the patients ignore requests for payment. Be sure to ask patients for their social security number – this will be helpful if you need to turn your non-payments over to a collector.
Maintain Electronic Health Records of Patients
The electronic health record is a record of a patient’s health information which is created by a meeting in a care delivery setting. This record includes demographics, problems, progress notes, vital signs, medications, any relevant past medical history, lab data, immunizations and radiology reports. Using EHRs will improve and automate your workflow.
It has the power to create a complete record of a patient encounter, and also helps other related activities, like outcomes reporting and quality management. Further, it will save your FQHC billing staff hours of time because it is so efficient. Medical billing professionals do not have to worry about dealing with unnecessary papers and files as the records are electronic.
If you start with these five tips, you will be on your way to more proficient FQHC billing in no time. These FQHC billing tips and strategies were provided by Practice Management a leading provider of medical billing services with a high degree of expertise in FQHC billing solutions.