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FQHC BILLING SERVICES

Tailored Medical Billing and Revenue Cycle Management Services Designed for Federally Qualified Health Centers.

Why Should You Outsource FQHC Billing?

Federally Qualified Health Centers (FQHCs) offer a diverse array of services and employ various medical professionals, resulting in intricate medical billing processes. Compliance with Centers for Medicare & Medicaid Services (CMS) regulations tailored for FQHCs is crucial, making outsourcing coding and billing to specialized professionals in medical billing and revenue cycle management (RCM) advantageous.

With over a decade of experience, our system has been refined to guarantee revenue enhancement for our clients. We meticulously review claims for errors before submission, adhere to each payer or clearinghouse’s requirements, and diligently track each claim until it is paid. Denial follow-up is included at no extra charge, and no claim is overlooked. Remote Expert Solutions offers billing services that optimize your center’s income and streamline the entire revenue cycle.

Experienced and HIPAA Compliant

Due to the wide array of services offered by FQHCs, it can be challenging for medical staff to stay updated on all current and accurate codes—especially considering the complexity of Medicare codes. At Remote Expert Solutions, our certified coders and billers possess extensive experience in FQHC billing services. Additionally, every team member undergoes training on HIPAA best practices to ensure secure handling of patient information and maintain organizational compliance.

The Challenges of Medical Billing for FQHCs

FQHCs serve a diverse patient population with a wide spectrum of healthcare requirements, necessitating that coders and billers possess expertise in numerous code sets. The complexity of billing for such medical facilities stems from several factors, including:

Per-Diem Payments

When a patient has multiple visits with an FQHC practitioner on the same day, these visits typically need to be billed as a single encounter, except in specific circumstances. For instance, exceptions may apply for a qualified mental health visit and a medical visit occurring on the same day, or if the second visit involves a distinct diagnosis, such as being seen initially for an illness and later for an injury. It’s imperative for billers to accurately discern the purpose of each visit and refrain from submitting separate bills unless warranted by these exceptions. Our billers undergo continuous training to ensure they are well-versed in the unique requirements of each specialty or organization they support.

Off-Site Visits

Qualified FQHC visits can occur not only at approved facilities but also at various locations such as the patient’s residence, a Skilled Nursing Facility (if covered by Medicare Part A), or even the site of an accident. Coding for these scenarios necessitates meticulous documentation of medical necessity and location details. Remote Expert Solutions medical billing software and training regimen ensure that billers stay informed about these specific requirements, including any variations across states.

Mental Health and Substance Abuse Coverage

Apart from medical visits, FQHCs often offer behavioral health care management and psychiatric consultation services. It’s crucial for medical coders and billers to be acquainted with these additional specializations and understand the CMS expectations for each type of visit.

Remote Expert Solutions Increases Payer Reimbursement and Assures Smooth RCM

Our Software Assures Use of the Current Codes

Our cutting-edge approach to FQHC billing services commences with our proprietary software, guaranteeing coders access to accurate codes, including the latest updates. It initiates the billing cycle upon the patient's initial appointment and streamlines the entire process until the claim is successfully paid.

Revenue Cycle Management from Start to Finish

In addition to our proficient team of medical billers managing claims, we provide a comprehensive range of RCM services. From payer credentialing and compliance reviews to coverage verification and annual payer adjustments and payback, we offer various solutions to streamline your workflow and enhance patient care.

Remote Expert Solutions services not only boost revenue but also alleviate the stress associated with billing concerns. Contact us today to discover how we can contribute to the success of your FQHC.

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