Integrated care models offer a comprehensive approach to healthcare delivery, particularly beneficial for Federally Qualified Health Centers (FQHCs). These models promote patient-centered care by coordinating services across various health providers. However, achieving operational efficiency while managing the complexities of billing in such integrated frameworks poses significant challenges. The intricacies of FQHC billing services become even more pronounced when coordinating care among multiple providers and specialties.
Successful medical practices must stay ahead of constant changes in the U.S. healthcare system. This includes new cuts to Medicare reimbursement rates putting your revenue at risk. Typically, these cuts are made through the physician fee schedule (PFS) and the hospital outpatient prospective payment system (OPPS).
Medicaid payments are a vital source of revenue for a community health clinic. As a federally qualified health center (FQHC), your practice relies on receiving a steady flow of Medicaid reimbursements.
When it comes to billing, Medicare reimbursement is a vital revenue stream for most federally qualified health centers (FQHCs). Yet many centers are missing out on the additional revenue they’re owed for Medicare Advantage patients.
This is a growing concern for FQHC billing as an increasing number of patients are choosing Medicare Advantage plans. Over the years, most beneficiaries opted for traditional Medicare plans, but a growing percentage of patients are enrolling in Medicare Advantage plans instead.
Are your associates fully up to date on the latest FQHC requirements? In the fast-paced world of healthcare, knowledge quickly goes stale and it’s a constant challenge to stay current.
The Health Resources and Services Administration (HRSA) has a long list of medical billing guidelines for FQHCs and other federally funded health centers. There are also strict FQHC requirements for Medicare, Medicaid, and other government payment sources.