A federally qualified health center (or FQHC) is also commonly referred to as a community health center (or CHC). FQHCs are community-based, patient-directed providers of primary health care that receives grants under the Public Health Service Act, Section 330. An FQHC traditionally serves under-served areas, offering the residents a sliding fee scale while still providing comprehensive health services.
Maintaining healthy revenue streams for FQHCs is often complicated and challenging. It is imperative to implement effective policies and billing procedures when offering health services to disadvantaged people. This is because many such people may still be unable to pay for the health services even at the heavily discounted fees if they are not covered by insurance.
There may also be some delays when getting the grants and reimbursements from the federal authorities.Therefore various departments in FQHCs need to collaborate efficiently and effectively in order to maximize revenues. This means streamlining patient billing processes which will help lower costs without compromising the quality of patient care or reducing their satisfaction. Here are some strategies that can help FQHCs to optimize their revenue streams and overcome financial challenges.
1. Invest in a reputable medical billing software
Installing a well-designed health center billing software will make operations smoother and more professional. It will facilitate better doctor to patent communication using modern channels such as the internet.
It should also allow for better collection and storage of all relevant patient information by the health staff. The information should include such details like insurance and even demographics immediately the patient visits the health center.
The modern practice requires such software to have ICD-10 so as to enable an expedited claim process and also cloud support.
Accuracy in recording information translates into a smooth and fast billing process. Examples of the best billing software for health centers include Office Practicum, NueMD, Benchmark Systems, Kareo and PrognoCIS.
2. Improve the patient records system
The FQHC staff should collect accurate information about the patients in digital form. This allows for easier access and effective billing. It is also essential to store such information in a data redundant center or even use secure cloud services to safeguard it.
In addition, all patient records need to be updated regularly even when the patients return to the health center. To ensure a streamlined billing process, all pertinent patient information should be available, including insurance, home address, telephone numbers and dates of birth.
3. Hire an FQHC medical billing consultant
Even after installing a high quality medical billing software, there is a need to hire a reputable medical billing professional who is experienced and knowledgeable about the entire billing cycle. FQHC medical billing consultants can help determine the best methods of sealing any billing loopholes after thoroughly researching and analyzing the unique challenges facing the health center. The consultant will also document and recommend the proper billing procedures that need to be followed.
It is important to use a medical billing consultant with the relevant expertise in a particular practice. For example, medical billing for a surgery is quite different from that of a health center.
4. Reduce revenue leakages
Many FQHCs will often adopt aggressive practices when hiring physicians. This extra expense can put a heavy burden on their income statements. It is advisable to exercise control when hiring extra physicians. This should only be done after taking the necessary measures to prevent revenue leakages such as out-of-network referrals. This is where such physicians refer patients to a competing health provider. The health center must efficiently and thoroughly optimize and automate referral practices.
5. Formulate clear patient communication strategies
For optimal revenue collection, an FQHC needs to communicate clearly to patients on the subject of its billing and financial policies. The patient needs to sign a document that they have read and understood such policies. The document will comprehensively explain issues such as terms of payment, authorization procedures and insurance information.