FQHC Billing Services

Most Practice Management (PM) System vendors offer medical billing/ 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?

There are many medical billing companies around, but PMG’s medical billing/ revenue cycle services are exclusively for FQHCs. With over 20 years of experience, PMG 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/ revenue cycle services are designed with only FQHCs in mind. Our goal is to remove the burden of medical billing so our FQHC clients can enjoy a healthy bottom line that leads to growth and expansion of patient services.

PMG goes beyond basic medical billing and offers true revenue cycle management. Our team of experts looks to improve every part of your revenue cycle. We look for the root of denied claims and work to improve all departments including the front desk/ eligibility, provider medical coding, and medical billing software optimization. By going beyond the medical billing department, we are able to identify the source of cash leaks at your FQHC and then work with your team to stop them at the source.

Provider Coding Training

With the rise of value-based care and quality payment models, medical coding is becoming an even more important part of the FQHC billing guidelines. While providers must enter the medical billing codes themselves, our revenue cycle/ medical billing, our team stays up to date on medical coding rules and guidelines so that you don’t have to. We continually monitor claims for denials and compliance issues stemming from medical coding issues. If your providers and/ or staff needs guidance, PMG clients enjoy unlimited custom medical coding training for your providers to get them up to speed. The training can be presented face-to-face, or we can create an online FQHC medical coding webinar for your team to learn at their own pace. Continually watching for medical coding errors allows us to stop medical coding related denials and help you increase your revenue.

Advanced Claim Denials Management

Our proprietary medical billing and coding denial management software is designed to track claim status and allows us to improve your first pass rate significantly. By identifying these medical billing trends, future denials are stopped before they can happen again, allowing your FQHC to collect fair payment for services provided. Our medical billing software works independent of your practice management (PM) system, meaning there is no need to change your current PM system. In fact, PMG is well versed in many of the top PM systems.

FQHC Benchmark Reporting

Speaking of PM Systems, we all know how frustrating this online medical billing and coding software can actually be. Even pulling reports can be a nightmare. That is exactly why PMG’s medical billing services include comprehensive monthly reporting that provides an executive level view of your billing performance. As billing systems vary in the sophistication and level of data tracked and do not produce this information in similar formats, PMG takes these stock reports and develops hybrid reporting options that work for your center. The end result is a seamless delivery of information. PMG’s clients also have the unique advantage of our extensive FQHC only reporting and benchmarking against FQHC peers. With over 2 million FQHC encounters processed annually, PMG’s medical billing reporting and benchmarking allow FQHC Administrators and Board Members to see strengths and future revenues opportunities clearly.

When looking for the right medical billing services for your FQHC you need to weigh many factors. Be sure that the vendor you select understands the FQHC world and all of the specific challenges you face. Know what services they provide and what you will still need to do on your own. At the end of the day you need to find a balance that is right for you and your FQHC.

Find Out About FQHC Billing from PMG