FQHC Billing Tips & Strategies for 2016

Maintaining the revenue of a federally qualified health center (FQHC) is far more complicated than we expect. It is mostly affected by delay in getting payment for medical services and patient billings. In order to maximize and improve the revenue from billings in FQHCs, all the concerned departments have to work professionally and efficiently.

The primary roles and objectives of a FQHC is to:

• Provide comprehensive medical services combined with a quality assurance program
• Be well equipped to serve an underserved population
• Enhance reimbursement from Medicaid and Medicare
• Bid a sliding fee scale for patients
• Have a prevailing board of directors

Therefore, FQHCs should implement effective procedures and billing policies while applying billing strategies that will help reduce costs, enhance revenue and improve the care and satisfaction of patients. To improve the medical billing process, federally qualified health centers should apply these five important strategies.

Comprehend the FQHCs Overall Revenue Cycle

Understanding your revenue’s overall cycle functions effectively and is very significant in improving the medical billing process. Billing officially begins right from the time of a patient’s appointment and ends when a specialist has attended the patient and makes the payments. All the staff members in a particular center play an important role therefore a FQHC should institute proper medical billing process channels that has the patient’s registration, payment costing and charge entry

Acquire the Right Resources 

A FQHC can acquire the correct resources by working with a qualified FQHC billing consultant that will guide you through any difficult situations and matters concerning your medical billing. There are also a number of medical billing softwares that you can use for your billing. They will make your work easier and it saves time too.

Record All Charges

Recording a day-to-day encounter form with an appointment will enhance a corresponding charge and patient attendance too. It is important to daily reconcile the total fee on the encounter forms in the reports which the running system generates. This will maximize the revenue since the health facility will be able to trace missing forms and prevent revenue loss through health center visits and nursing homes. The most preferred method that most centers use to capture charges is by using the preprinted index cards.

Share Financial Policies With Patients

A federally qualified health center should share its financial policies and billing to their patient. You can simply use a single-page document to summarize all your financial policies and should be signed by every patient and placed in their file. Especially when developed with an experienced and professional FQHC medical billing company, the policy should clarify the authorization, terms of payments, insurance information and cancelation and collection policies.

Update & Review Fee Schedules

Updating the fee schedules annually with reasonable charges will maximize billing revenue in any FQHC. Before charging any fee, it is important to first compare the fees with other Medicare or contracted fees charged by a health center billing service. Most insurance companies pay lower than the billed or contracted amount therefore, any billing lower than the contracted amount is likely to lose revenue in any health facility.

Although there are other tips and strategies to improve the medical billing process for FQHCs, these 5 strategies will be very beneficial to keep any federally qualified health center financially stable and healthy.