There's no question that most federally qualified health centers (FQHCs) are severely perplexed and burden by the complexities of FQHC billing and coding. Unlike other forms of medical billing, FQHCs face further difficulties due to their unique, community-based patient scope, as well as their lack of resources and technology.
If you operate a FQHC and are facing difficulties with patient billing and coding processes, read on before investing in expensive software, or hiring a professional for FQHC patient billing services. The resources outlined below offer actionable help to make for more efficient and effective FQHC billing and coding.
The FQHC Billing Guide by iFinance is a great resource for anyone in the FQHC billing and coding field. Accessing the URL, you will find a power point presentation converted to a PDF file for online viewing. The document succinctly and clearly articulates the responsibilities of the FQHC billing. You can find details on denials versus returned claims and provides a good explanation, with examples, of each.
The causes of lost revenue are fully identified and explained. The denials section goes into the right amount of detail regarding the types, sorting by department and specific plans of action to address the denial.
There are also various useful flowcharts scattered throughout the presentation that are practical and a useful tool for developing or dealing with the FQHC billing at FQHCs.
There are plenty of examples that give the reader a good understanding of the various nuances involved in the FQHC billing process. There are some good insurance tips included. The presentation too does not take its eye off the purpose of FQHC billing: getting paid.
Learn more about the FQHC Billing Guide by iFinance at www.scphca.org.
The Synergy Billing Academy offers onsite or online training for everything related to the FQHC billing process. The company offers detailed courses in five areas: FQHC Billing, FQHC Coding, Billing Claim Denials, ICD-9 Training, and ICD-10 Training.
Their online training courses are broken down into a course list offers training modules directed towards IT, Clinical, Leadership, Administrative, and Leadership. The length of each course is specified also. The courses are specifically for certain types of IDC-10-CM too. There are courses for Dental, Mental Health, OB/GYN/Family Medicine and more.
The onsite instruction offers the same courses. The two-day onsite course provides comprehensive and specialized training for all Federally Qualified Health Centers.
To learn more about FQHC Billing Training by Synergy Billing Academy, visit www.synergybillingacademy.com.
The Rural Assistance Center is a great site with a comprehensive list of websites and tools related to FQHC billing. There are sites that have webinar recordings with lectures and information sessions. There are various links to sites that list requirements, specific billing issues, and many more. Some of them are Federal Government sponsored and many are private organizations.
The site menus include a page with links to various useful publications in the FQHC field. Relevant CFRs, fact sheet lists, and many more are included. A total of 74 different sites related to FQHC publications are hyperlinked on the page, with short synopsizes of each one.
One link lists nothing but funding opportunities. There is a peer-to-peer fund sharing link along with ideas and ways to reduce the costs of medication purchases.
The links to events and news are up to date. Each event from around the country has a brief synopsis regarding the specifics of the event and who is the intended audience. There is a list of guidelines for each state too which allows you to review any nuances in the billing process related to thes pecific state.
A very useful link includes model rural community centers. There are various "best practices" in billing and other FQHC topics discussed too. Visit www.raconline.org, to learn more about the Assistance Center.
This site, provided by Medicaid University, offers 100 Frequently Asked Questions regarding FQHC billing. The questions are practical and realistic. They include simple questions such as where do I find a list of revenue codes, to practical matters such as can I bill bandages for a patient along with his office visit.
There are a number of hyperlinks also that are very useful for FQHC billing in general. Some of the questions involve, "where do I find…" and in the answers, they provide appropriate links to comprehensive publications that have the answers.
You can find the One Hundred FQHC Billing Questions PDF at c.ymcdn.com.
This link will lead you to a 90 page PowerPoint PDF authored by Medicaid University with a detailed explanation of everything to do with FQHC billing. The text is broken up into key areas including reimbursement methodology, covered services, FQHC billing, telehealth services and supplemental payments.
Download the complete PDF of Basic Billing Guidelines for FQHCs by Medicaid University and click here.