Coronis Health, FQHC & CHC
FQHC Medical Billing Services
Medical billing and revenue cycle services designed specifically for FQHCs and CHCs to optimize their revenue cycle.
Coronis Health’s medical billing and revenue cycle services are designed specifically for FQHCs and CHCs to optimize their revenue cycle and create increased cash flow by identifying and capturing missed revenue. We truly admire the outstanding work that FQHCs and CHCs deliver. We recognize the tremendous need for your services and have made it our mission to assist centers like yours in the achievement of their financial goals.
Most Practice Management (PM) System vendors offer medical billing and revenue cycle management as an “add-on” service. They may send out claims and post payments but are they working to identify and correct the source of your denied claims? Do they understand the world of Federally Qualified Health Centers (FQHCs) and the revenue cycle challenges you face every day? Most importantly, are they leaving money on the table, money your FQHC deserves?
Understanding FQHC Medical Billing
Billing for federally qualified health centers (FQHC) requires a full understanding of the unique nature and structure of these types of centers, their challenges and limitations, and a fundamental understanding of Medicare and state Medicaid billing as well.
The complexity of billing for FQHCs reaches beyond the typical billing for commercial insurance. Because these centers are funded by the federal government and grants, specific coding is necessary to ensure that all services are captured accurately and that billing practices are compliant with the rules and guidelines set forth by the Centers for Medicare and Medicaid (CMS) and the Health Resources and Services Administration (HRSA).
Coronis Health offers FQHC medical billing services that focus on providing more than just billing and coding expertise. The billing professionals at Coronis also understand the reporting requirements for FQHCs, and focus on the full picture of revenue cycle management to ensure that profits increase, days in A/R decrease, claims are clean, and the FQHC is operating at its highest potential.
What are FQHCs
Federally qualified health centers (FQHCs) fall into any of the following categories:
- A center that receives grants based on the requirements outlined by the HRSA
- Tribes or tribal organizations that operate functional outpatient clinics or facilities as outlined in the Indian Self-Determination Act, and also chooses to operate as a FQHC
FQHCs provide primary care services to underserved or uninsured populations, and are sometimes referred to as “safety net” hospitals or facilities. The following are considered FQHCs:
- Community health centers
- Public housing centers
- Outpatient health programs funded by the Indian Health Service (IHS)
How is medical billing for FQHC’s different?
FQHC billing is remarkably different from billing for commercial insurance, as many centers operate with Medicaid, which reimburses at a much lower rate. Additionally, changes from CMS release changes and updates that significantly affect the billing and coding process, such as the recent billing requirements for telehealth related to the COVID-19 pandemic. Billing for FQHCs is also based on the location where services are rendered. No matter what challenges you might face with your FQHC billing, Coronis Health has the experts that optimize your billing needs.
Benefits of Outsourcing your FQHC medical billing
The challenges of keeping billing staff within your facility stretch past the typical concerns of increased A/R or claim denials. Outsourcing billing services for a FQHC means that your staff have time to focus on the operations of the facility to ensure that the clinical staff are providing excellent patient care.
The intricacies of medical billing for a federally qualified health center should be managed by experienced billers and coders who fully understand Medicare and Medicaid, the requirements for billing for grant and federally funded programs and facilities, and how to maximize the reimbursement and profits for the center. When you choose Coronis Health for your FQHC medical billing services, rest assured you will maximize your profits, accomplish your goals, and maintain a high level of patient satisfaction and outcomes.
How We’re Different
Not only do we take care of billing, but Coronis Health also works to improve every part of your revenue cycle. Our forward-thinking team of experts looks below the surface, identifying and helping you fix the workflow issues that are negatively affecting your reimbursements including the front desk, provider medical coding, practice management (PM) system optimization, and extensive denials management. By going beyond the billing department, we are able to identify the source of cash leaks and then work with your team to stop them at the source.
Our proprietary medical billing and coding review software is designed to track claim status and allows us to improve your first-pass rate drastically. By identifying these medical billing trends, future denials are stopped at the source, and your facility can collect every dollar you deserve. Our medical billing software works independent of your practice management (PM) system, meaning there is no need to change your current PM system. Coronis Health is well versed in many of the top PM systems.
Coronis Health can help you improve in the following areas:
- Front desk concerns, including eligibility
- Provider coding accuracy (CPT, ICD-10)
- EDI challenges and systems interfacing
- Claim scrubbing and submissions
- Clearinghouse communications
- Denial reporting and prevention
- Charge entry and payment posting
- Long-term revenue cycle growth strategies
Experience Your Center Needs
With over 100+ years of combined experience, the Coronis Health team of experts knows FQHC medical billing and coding. We are well versed in sliding scale, UDS reporting, cost-based Medicaid reimbursement, school-based health centers, dental claims, substance abuse/detox billing, UGS/NGS Medicare, and other FQHC-centric specialties. Our medical billing and revenue cycle services are designed with FQHCs and CHCs in mind. Our goal is to remove the burden of medical billing so our clients can enjoy a healthy bottom line that leads to growth and expansion of patient services.
Our high-touch approach features a customer service team that is knowledgeable, courteous, and always efficient. Our multi-lingual team strives to provide an exemplary experience to each of your patients. From our COO to our call center staff, Coronis Health believes that every member of our team is a key part of our client’s success story. We believe that we succeed only if you do.
Why Choose Coronis Health as your Billing Partner?
When looking for the right medical billing services for your FQHC, you need to weigh many factors. Should you go with the same company that offers medical billing software as part of their practice management software? Oftentimes, the medical billing services offered by these companies is not true revenue cycle management. Are they working denials to ensure you get paid? Can they help optimize your practice management software? Do they offer solutions to improve medical coding? Will you get the medical billing and coding reports that you need to plan for success? You must carefully weigh all of these options and ultimately decide which medical billing/ revenue cycle management company is right for your center.
Results of a Coronis Health optimized revenue cycle include:
- Increased revenue
- Decreased days in AR
- Reduced denials
- Higher average encounter rates
- Accelerated and steady cash flow
- Increased clean claim rates
- Lower processing costs per claim