Federally Qualified Health Centers (FQHCs) offer a comprehensive range of services and employ various medical professionals, which can make medical billing quite complex. Accurate coding is crucial and must adhere precisely to the special guidelines set by the Centers for Medicare & Medicaid Services (CMS) for facilities designated as FQHCs. To navigate this complexity, many FQHCs find it beneficial to outsource their coding and billing to professionals who specialize in medical billing and revenue cycle management (RCM).
Our system has been refined over a decade of experience, enabling us to guarantee that our services will enhance our clients’ revenue. We meticulously “scrub” claims for errors before submission, ensuring they comply with each payer or clearinghouse’s requirements. We also track each claim until it is paid and follow up on any denials at no additional cost, never overlooking a challenging claim. Med Billing RES provides billing services that maximize your center’s income and streamline the entire revenue cycle.
Medicare & Medicaid Services (CMS) special rules for facilities designated as FQHCs, so it has proven beneficial to outsource coding and billing to professionals who specialize in medical billing and revenue cycle management (RCM).
Our system has been perfected through a decade of application, and we are now able to guarantee that our services will increase our clients’ revenue. We “scrub” claims for errors prior to submission, submit according to each payer or clearinghouse‘s requirements, and then track each claim until it is paid. We follow up on denials at no additional cost, and never just ignore a difficult claim. Med Billing RES provides billing services that maximize your center’s income and streamline the entire revenue cycle.
Because FQHCs offer so many different kinds of services, it is difficult for medical staff to be aware of all the current correct codes–and Med Billing codes can be very complicated. Med Billing RES provides coders and billers who are not only certified, but also have experience providing FQHC billing services. Every employee is also trained on HIPAA best practices to ensure that patient information is handled securely and your organization remains compliant
If a patient sees an FQHC practitioner more than once in a day, it should be billed as a single visit, unless it's for a qualified mental health and medical visit on the same day, or if the second visit involves a different diagnosis, like coming back later for an injury after an earlier illness visit. Billers need to carefully review the purpose of each visit and avoid submitting separate bills unless one of these exceptions applies. Our billers undergo regular training to stay updated on the specific requirements of every specialty or organization they support.
Qualified FQHC visits can happen not just at approved facilities but also at the patient’s home, a Skilled Nursing Facility (if covered by Medicare Part A), or even the scene of an accident. Proper coding for these situations must clearly document both the medical necessity and the location. Med Billing RES’s medical billing software and training system ensure billers stay informed about these specific requirements, including state-by-state differences.
Along with medical visits, FQHCs often offer behavioral health care management and psychiatric consultations. Medical coders and billers need to understand these specializations and be aware of CMS expectations for each type of visit.
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