When Congress finally approved the Section 330 Grants under the Bipartisan Budget Act of 2018 benefiting CHCs and FQHCs in early February, there was a collective sigh of relief within many centers. With that Congressional approval, centers now have two years of extended funding, including $600 million dollars to support operations and address unmet need in their communities; plus workforce support through The National Health Service Corps and the Teaching Health Centers Program. But it had been a long nearly 5 month period since the grants had expired, and it would take some time to reverse the damage done in many communities that lost services and other resources. According to The Kaiser Family Foundation, Many considered layoffs, reducing center hours and 20% of centers had instituted hiring freezes, with a total of 45% considering freezes. 25% canceled or delayed renovation/expansion plans that were much needed in the process of providing care.
Returning to the Revenue Cycle
For centers, simply turning on the revenue faucet doesn’t happen that quickly. After months of disruptions to funds and services like indigent care and mental health, trying to get back to normal may be a challenge. Grants must be re-applied for and during the recertification process, patients still need care. But the funds that were there to help make up the difference dried up months ago and charges may still be continuing to pile up while awaiting grant approval. Revenue cycle workflows may have been disrupted with staffing changes or reallocations to other necessary functions. Getting revenue back in the door sooner could be helped by looking back into self-pay balances that have not yet been written off.
Opportunities in Your Self Pay
In many states, a patient is eligible for retroactive coverage for three months prior to the month in which an application is filed, allowing the provider to bill for services provided and billed as self-pay. But the exceptions, details, and potential losses that providers face around the retroactive eligibility question run much deeper as section 1115 waivers become more complex for both the patient and the provider. Working with a partner like Altruis in a contingency model can allow a center to take advantage of collecting on self-pay balances without added strain on RCM workflow. With recovery rates averaging between 15%-20% of self-pay, these funds can have significant impact on margins and put additional resources back to providing care to those truly in need.
Billing Specialists to FQHCs
Altruis works within a centers existing EHR to provide billing services that emulate the workflow of an internal team. Our focus is to shift the burden of center business away from the care providers so that they can focus on caregiving goals. Our service is seamless and supports your center by providing convenient billing, compliance and other aspects of the revenue cycle. Think of it this way: You have accountants and money-managers within every established business. You also have personal accountants that help file special reports like Federal income tax and other claims. Seeking out these professionals helps you get back all the money you have coming to you, while also making certain you fulfill your total obligation. With outsourced billing personnel, you are essentially doing the same thing for center revenue cycle management.
Altruis is more than the typical billing service. As our name implies, our core values are set around providing more resources to empower our clients in the mission of serving others. Want to learn more about how you can finally get off of the funding cliff? Check out our RetroPayTM and Billing Solutions at http://www.altruis.com/or contact us today.