It has been helpful to outsource coding and billing to professionals who specialize in medical billing and revenue cycle management (RCM) because Medsurebilling recognizes that Federally Qualified Health Centers (FQHCs) employ a variety of medical professionals and provide a wide range of services, making medical billing particularly complex. Coding must be completed precisely as specified by the Centers for Medicare & Medicaid Services (CMS) special rules for facilities designated as FQHCs.
Because Medsurebilling understands that Federally Qualified Health Centers (FQHCs) employ a variety of medical professionals and provide a wide range of services, making medical billing particularly complex, it has been beneficial to outsource coding and billing to experts who specialize in medical billing and revenue cycle management (RCM). For facilities classified as FQHCs, coding must be done exactly as outlined by the Centers for Medicare & Medicaid Services (CMS) specific guidelines.
Medsurebilling offers coders and billers who are not only certified but also have experience providing FQHC billing services. Each employee is also trained on HIPAA best practices to ensure that patient information is handled securely and your organization stays compliant. This is because FQHCs provide a wide range of services, making it challenging for medical staff to know all the current correct codes – and Medicare codes can be very complicated.
With the exception of a qualified mental health visit and a medical visit on the same day, or if the second visit necessitates a separate diagnosis (e.g., being seen once for an illness and returning later that day with an injury), a patient visiting a FQHC practitioner more than once on the same day must be billed as a single visit. Our billers are required to pay close attention to the purpose of each visit and make sure they do not submit separate bills if neither situation applies.
In addition to authorized facilities, qualified FQHC visits may also be conducted at the patient’s home, a skilled nursing facility (if Medicare Part A covers it), or even the scene of an accident. For any of these circumstances, the location and medical necessity must be precisely documented in the coding. The training program and medical billing software offered by Medcare MSO guarantee that billers remain current on these particular regulations, including the variations between states.
Psychiatric consultation and behavioral health care management are additional services that FQHCs may offer in addition to medical visits, and medical coders and billers need to be knowledgeable about these extra specialties as well as CMS requirements for such visits.
Our proprietary software, which begins our innovative approach to FQHC billing services, ensures that coders have the correct codes, including the most recent updates. It begins the billing cycle when the patient first schedules an appointment and expedites the entire process until the claim is paid.
We provide a comprehensive range of RCM services in addition to having a skilled team of medical billers to manage claims. We may assist in streamlining your process and promoting high-quality patient care in a number of ways, including payer credentialing, compliance reviews, coverage verification, and annual payer adjustments and payback.
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