Tuesday 22nd December 2015

by admin

Optimizing the health care billing systems, especially for federally qualified health centers (FQHCs) and community health centers (CHCs), is a far more complex process than what many people expect. In FQHCs and CHCs, there are diverse departments that need to collaborate well so as to improve patient billing.

When providing health services to disadvantaged people, there is need to implement effective billing procedures and policies. Why? Because many patients may be unable to pay for health services even at discounted fees if insurance does not cover them. For this reason, proven billing strategies need to be implemented to increase revenue and lower costs of services while maintaining top patient care and satisfaction.

chc fqhc billing strategies

Common Challenges With Health Center Billing Systems

An average health center has a collection and insurance billing rate of about 70% excluding self-pay and slide patients. As both CHC billing and FQHC billing are specifically tailored with many billing codes and components, it often becomes challenging to pinpoint bad chains and breakdowns in the billing process. The following are some of the causes of bad chains and breakdowns in the billing process:

  • Failure to redirect the claims properly
  • Physicians omitting some services given during the office visit
  • Failure to work on denials promptly
  • Failure to file the claims promptly
  • Failure to collect minimum and co-payments fees
  • Failure to collect previous patient account balances
  • Failure to get current patient information

Improved billing systems of FQHCs and CHCs, should require:

  • The billing of patients to be done as per the set schedule of discounts
  • A corresponding schedule of all the discounts
  • A timely follow-up on all the uncollected amounts
  • A competitive and adequate fee schedule

Proven Strategies for Health Center Billing

While many of these strategies for health center billing can be applied in-house, some find it easier to leverage these systems and strategies by working with a medical billing company. If your practice chooses to recruit the help of specialized billing provider, then be sure to find a company that specializes in your specific practice. For instance, if you operate a CHC or FQHC, you should invest your resources in a proficient FQHC billing company, like MaximizedRevenue.com.

1. Invest in Billing Software

A good health center billing software should make things much easier and professional. On the other hand, it should make it possible for the doctors to communicate with their patients through modern media like the internet or even phone calls.

health center billing software

Also, it should allow the health staff to collect and store accurate patient information easily; that includes insurance and demographics once he or she visit the health center. The modern trends require the software to have ICD-10 to expedite the claiming process and cloud support.

If the information recorded is accurate, it means the billing process will be smooth and fast. Some of the top health center billing software include NueMD, PrognoCIS, Office Practicum, Kareo, and Benchmark Systems, just to mention a few.

2. Improve Upon Patient’s Records

For effective billing, easier access, and processing, the FQHC and CMC staff should collect accurate patient information in digital form. The collected data should be stored in redundant data centers or to the cloud that has high security to ensure they are not lost or stolen.

On the other hand, all the patients’ records should regularly be updated even after the patient revisits the health center. For effective billing, some information must be available including home address, telephone numbers, birth dates, and insurance information.

3. Recruit a Medical Billing Consultant

Even if a top medical billing software is available, there is still the need to have a medical billing consultant who has a clear understanding of the whole cycle of billing. A medical billing consultant is useful in determining the correct measures that should be taken to seal the billing loopholes after carefully doing some research contingent upon the challenges a particular health center is facing. Also, the medical billing consultant can document the proper billing channels that should be followed.

Lastly, and to reiterate the point above, find a medical billing consultant with expertise in your specific practice, whether that be OB/GYN, pediatrics, CHC, or surgery. medical billing for health centers is far different than that of surgery, so this is vital consideration to realize a good ROI in recruiting a billing consultant.

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