METACARE services increase revenue by eliminating lost and rejected claims, so our clients benefit from more income and reduced stress because they don’t have to worry about billing any more. Contact us today to get a free demo.
FQHC BILLING SERVICES
Federally Qualified Health Centers serve underserved patients with greater responsibility. This unique medical specialty requires greater attention to collect reimbursements and an all-inclusive model to streamline the payment system. METACARE focuses on the harmony of revenue cycle management and abides by the requirements that are essential to keep your business running smoothly.
FQHC Billing Services Provided by METACARE MSO
Federally Qualified Health Centers (FQHCs) provide a wide range of services and employ a variety of medical professionals, which means medical billing can be especially complex. Coding must be done exactly as specified by the Centers for Medicare & Medicaid Services (CMS) special rules for facilities designated as FQHCs, so it has proven beneficial to outsource coding and billing to professionals who specialize in revenue cycle management (RCM).
We Are Trained On HIPAA Best Practices
Medicare codes can be very complicated, and because FQHCs offer so many different kinds of services, it is difficult for medical staff to be aware of all the correct codes. METACARE provides coders and billers who are not only certified, but also have experience providing FQHC billing services. Every employee is also trained on HIPAA best practices to ensure that patient information is handled securely.
Per-Diem Payments
If a patient has more than one visit with an FQHC practitioner in the same day, they must be billed as one visit, with the exception of the visits being a qualified mental health visit and a medical visit on the same day or if the second visit requires a separate diagnosis, such as being seen once for an illness and returning later that day with an injury. Billers must be attentive to what each visit was for and make sure not to submit separate bills if neither exception applies.
Off-Site Visits
Qualified FQHC visits not only take place at approved facilities, but may be at the patient’s residence, a Skilled Nursing Facility (if covered by Medicare Part A) or even the scene of an accident. The coding for any of these situations must carefully document the medical necessity and location.
Mental Health And Substance Abuse Coverage
In addition to medical visits, FQHCs may also provide behavioral health care management and psychiatric consultation. Medical coders and billers must be familiar with these additional specializations and the CMS expectations for each type of visit.
METACARE Increases Payer Reimbursement and Assures Smooth RCM
Our Software Assures Coders Have The Correct Codes
Our innovative approach to medical billing starts with our proprietary software that assures coders have the correct codes including all the latest updates. It picks up the billing cycle when the patient first makes an appointment and streamlines the entire process until the claim has been paid.
We Will Submit Claims And Manage Any Rejections
In addition to having an expert staff of medical billers to scrub and submit claims, then manage any rejections or denials, we also offer payer credentialing, compliance reviews, and annual payer adjustments and pay back.