FQHC Billing Services
A Medi Solution understands the complexities of billing for safety-net providers. Managing diverse patient populations, complex billing codes, and adhering to federal and state regulations is challenging. Our FQHC billing services ensure accurate claims, reduce denials, and can boost your revenue by up to 30%. Let us handle your billing challenges so you can focus on delivering essential care to your community.
Why Outsourcing FQHC Billing Services Boosts Efficiency and Revenue
Federally Qualified Health Centers (FQHCs) offer diverse services and employ a range of healthcare professionals, making billing especially challenging. Accurate coding must follow CMS-specific guidelines for FQHCs, which is why outsourcing to specialists like A Medi Solution is a smart move. With over a decade of experience, our proven billing system helps maximize revenue, reduce claim denials, and streamline your entire revenue cycle. We rigorously check claims for errors, submit according to payer-specific rules, and follow up on every claim—at no extra cost—until it’s paid.
Trusted, Experienced, and Fully HIPAA-Compliant Billing Experts
Due to the wide range of services offered, FQHCs face unique challenges in staying current with complex Medicare and billing codes. A Medi Solution offers certified, experienced coders and billers who specialize in FQHC billing services. Every team member is fully trained in HIPAA compliance to protect patient data and ensure your organization meets all regulatory requirements.
Key Challenges in FQHC Medical Billing and How to Overcome Them
Federally Qualified Health Centers (FQHCs) treat a diverse patient population with a wide range of medical needs—making accurate coding and billing especially challenging. Coders must be proficient with a variety of specialty codes and billing regulations to ensure proper reimbursement. Below are some of the key reasons FQHC billing is uniquely complex.
Per-Diem Payments
FQHC billing rules require that multiple visits by the same patient on the same day be billed as a single encounter—unless the second visit involves a separate diagnosis or is a qualified mental health and medical visit. For example, if a patient is treated for a cold in the morning and returns later with a sprain, both can be billed separately. Otherwise, submitting two claims can result in denials. At A Medi Solution, our billing team undergoes continuous training to stay current with the nuanced billing requirements for FQHCs, ensuring accurate submissions and full compliance.
Off-Site Visits: Billing with Precision and Compliance
FQHC practitioners often provide care outside of traditional clinic settings, including home visits, nursing facilities, schools, and shelters. Each off-site encounter must be documented and coded correctly to meet CMS and payer requirements. At A Medi Solution, we ensure accurate billing for off-site services by applying the correct place-of-service codes and modifiers, preventing denials and delays. Our expert billers understand the unique nuances of mobile and community-based healthcare billing—ensuring you get paid for every service delivered.
Mental Health and Substance Abuse Coverage: Billing with Expertise
FQHCs often provide critical mental health and substance abuse services, which require specialized billing practices. Mental health visits, including therapy and counseling, and substance abuse treatment services must be billed with the correct codes and modifiers to ensure proper reimbursement. At A Medi Solution, we are experts in navigating the complexities of mental health and substance abuse billing for FQHCs. We ensure that all services are coded according to the latest CMS guidelines and payer-specific requirements, minimizing denials and optimizing your center’s revenue.
A Medi Solution Increases Payer Reimbursement and Assures Smooth RCM
Our Software Assures Use of the Current Codes
At A Medi Solution, our approach to FQHC billing starts with cutting-edge proprietary software that ensures coders use the most accurate and up-to-date codes. From the moment a patient schedules an appointment, our software seamlessly manages the billing process, ensuring efficiency, accuracy, and faster claims processing. This innovative solution minimizes errors, maximizes revenue, and helps reduce administrative burden, allowing your practice to focus on providing quality care.
Comprehensive Revenue Cycle Management from Start to Finish
In addition to our expert team of medical billers handling claims, we provide a comprehensive suite of revenue cycle management (RCM) services. Our offerings include payer credentialing, compliance reviews, coverage verification, and managing annual payer adjustments and paybacks. These services are designed to streamline your workflow, reduce administrative burdens, and ensure that your practice operates efficiently, ultimately supporting the delivery of excellent patient care. Let us handle the complexities of RCM while you focus on what matters most—your patients.