Practice Management: Making Medical Billing Easy for FQHCs

Practice Management has been cultivating expertise in medical billing management for more than 2 decades now. With their experience in billing for FQHCs and various other medical practices, the company has been in a position answer more than 100 frequently asked questions about Federally Qualified Health Centers medical billing and all aspects of the health facility revenue.

Medical facilities and healthcare service providers are often faced with a dilemma of which services are eligible for FQHC billing. Consultants at Practice Management have diversified their services to helping clients with reimbursement, patient claims, etc. This company knows that numerous medical issues arise, and most of them are unique to the hospital or service provider. Therefore, it's the medical billing company's responsibility to determine whether the new or unique services are eligible for billing hence reimbursement under the FQHC patient billing.

The scope of the Practice Management is to help FQHCs maximize their revenue from the services and treatment they offer all of their patients. This company utilizes state of the art modern medical billing software technologies that make the process of recording, submitting and following up on claims quick, transparent and easy. The company has dedicated staff who deliver more than their client’s expectations when it comes to identifying and updating health services that are eligible for claims.

An Influencer in the Medical Billing Community

As a leading FQHC medical billing company, Practice Management is always ahead of the community when it comes to the latest information and medical billing practices. The company must know the progress in the health sector with regard to the purpose and function of different stakeholders. For example, both the insurance companies and the federal government update their health policies. Financing and spending are always a highly sensitive topic.

For this reason, a medical biller should bring to the table, interpret and execute the updated financial and non-financial policies for the healthcare provider. Practice Management is up to this task and is likely to update the billing system to include at least two new inclusions to the billing system for the healthcare services provider.

If your healthcare facility is FQHC approved, experts at Practice Management will be quick to remind you that insurance companies will not come up front to suggest the new inclusions in billing. You're responsible for billing and submitting your claims, but your billing company is more responsible is assisting you to do this. Practice Management is best at this.

FQHC Billing Consulting Services

The best FQHC medical billing consulting company in the U.S. market today is responsible for health facilities sustainability. Patients, employers who are submitting employee medical insurance and insurance companies who are reimbursing health charges will not be quick to submit funds to health care facilities for any services.

Each of the above stakeholders is working to protect their economies. Health facilities, being polite and providing humanitarian services, will be vulnerable. It won't be a good picture to offer high-class health services, without watching the impact of insufficient funding.

Practice Management deploys highly qualified accountants who will review and audit the FQHC health facility’s revenue cycle to determine the correct maximum income that will favor the facility’s economy. To learn more about Practice Management's FQHC billing services and consulting programs, visit MaximizedRevenue.com.

FQHC Billing Services: How to Protect Your Investment

Most physicians and federally qualified health centers (FQHCs) will face this one questions sooner or later: whether or not outsource your patient billing demands to more specialized medical and FQHC billing companies?

While there are many different FQHC billing software platforms and FQHC billing webinars available in the market, they are unable to outdo the efficiency of proficient medical billing companies. Hiring a third party to manage your FQHC medical billing is specially a good idea if you have a high staff turnover or you are someone who has stayed away from technology all your life.

These medical billing companies are capable of significantly increasing your revenue. You will finally be able to do without your inadequate billing staff. The company you hire will not only generate claims, they will also follow up with patients and ensure that all due payments are made in time.

Since there are many FQHC billing companies operating in the market, you must practice caution while hiring a third party to manage your billing. Here are a few things you must keep in mind when looking to invest in FQHC billing services that ultimately enables health centers to maximize revenue streams.

1. What are the services being offered?

FQHC billing companies, like MaximizedRevenue.com, can take over many functions, such as claim generation and submission, payment processing, creating invoices for patients, collection services, etc. Some billing companies also handle tasks like appointment scheduling and credentialing. However, the price tag increases with each new service. As a physician, you must ensure the FQHC billing company you hire takes care of all your requirements and does so at a reasonable price.

2. What is the technology being used?

Using a billing company does not mean you are acquainted from your responsibility. To reduce costs, it is necessary for a physician to understand how a medical billing company will operate.

• It is important to seek answers to questions like these: 
• How will claims be generated and shared? 
• How will the billing company maintain electronic records and how can these records be used by the hospital? 
• Will the FQHC billing company ensure data security? 
• Where will all the data be backed up and stored?

A good medical billing company will have clear answers to all these questions.

3. Are they experienced?

Hire a company that's been in business for a while. Though experience does not guarantee efficiency, it certainly builds up trust. Look for a company that is certified by the American Medical Billing Association. The AMBA certification evinces expertise in billing, insurance claims, reimbursements, fraud and abuse, medical technology and terminology, etc.

4. How does the company work?

A good way to gauge the performance of an FQHC billing company is to study their work structure. Different metrics like employment structure and number of employees, total years in business, number of claims processed in any financial year, total number of billings, etc, will give you an idea about the kind of results you can expect from the billing company you are hiring.

5. What is the price being demanded?

Money is an important thing. As a matter of fact, medical billing companies are hired to reduce the overall billing costs. Hire a company that is offering maximum services at a minimum price. Do not demand services you won't need. Ask the billing company to create a cost package based on only the services you will be availing.

How to Outsource Medical Billing Services to the Right Company

It is important for medical clinics and health centers to maximize their reimbursements to ensure they do not lose money and at the same time remain compliant. Medical billing and coding normally entails reading notes and medical files of medical practitioners and translating the prescriptions, diagnosis, and services provided into the appropriate codes for purposes of insurance claims.

A medical billing service provider submits the claims to the insurers and follows up on any denied claims. Medical billing mainly involves talking to insurers on phone to follow up on late payments or denied claims.

Outsourcing medical billing and coding eliminates stress and headache involved when performing these functions. It is highly advisable to leave such tasks to the experts. Here are tips for choosing the right billing services for a health center or clinic.

Sympathy & Diligence

All health providers should get paid for services rendered based on clinical guidelines, medical necessity, patient eligibility and benefits and reimbursement policy. The billing and coding company must be willing to fight so that claims are paid appropriately and reimbursements are done in a timely manner.

Good, Verifiable References

References are crucial to vouch for the billing company’s credibility. Whatever claims they make about themselves and what they intend to do in order assist the clinic or health center with billing and coding must be backed by verifiable and credible references.

Give Value & Offer Extra Benefits

A good billing service should do more than just entering charges, collecting money and getting paid by percentage. They should also be able to go for the extra mile to take care of the health center or clinic. For example they should check if the claims are properly coded and billed or whether all services and number of units are billed.

The company should have the knowledge and experience to put extra values in their work. They should be able to recommend a better method of billing and coding and educate the clinic or health center based on their knowledge from school and real hands-on experience. It is often a good idea to ensure the billing service provider has coding certifications. They should therefore be willing and in a position to offer free consultancy and support at no additional cost.

A Specialty-Focused Approach 

Select a billing company with years of experience in the health center's or clinic's area of specialization. This will ensure reimbursements are maximized and are also in line with the proper guidelines.

For instance if it is a cardiology clinic, the right billing service is one that has an existing cardiologist client or has vast experience providing an effective cardiology billing service. The billing company must have the ability and experience to read and properly process medical documentations relevant to the health center or clinic, for instance lab results and various progress and diagnostics reports.

This guarantees that money is not lost and yet compliance is maintained. The billing company should also provide comprehensive monthly reports for example productivity reports and patient and insurance balances aging analysis

Keenly Look at the Numbers

The medical billing company must be conversant with insurance EOBs (explanations of benefits). The company should know how to recover all underpayments and appeal for claims that have been denied erroneously. They must know about the health center's or clinic's contract rates and make a judgment on when is the right time to renegotiate the fees. They can offer guidance on how to negotiate for fees or even do the negotiations at no additional cost.

Access to the Clinic's or Health Center's Account

The billing service should allow the clinic or health center to get full and secured access to their account anytime. They should also give full access rights where one can, for example, look up all patient accounts and print reports. In addition, a billing company of good repute will prepare and send frequent patient statements, for example every fortnight.

Reputation of Quality Customer Service

The billing company must have excellent customer service. It should be accessible on phone or have a turn-around time of less than 2 hours when responding to an email or phone call. Preferably, it should provide one team leader or contact person to handle the health center's or clinic's account.

Effective Medical Billing Strategies to Increase Healthcare Reimbursements

It is an undisputed fact that the healthcare reimbursement system (as it is) can be described as brutal. The present set of processes and rules that some payers and insurance companies have put in place are not only complex but also confusing. This leads to the emergence of other problems like underpayments, denials, ignored or at times lost claims.

This has hugely contributed to issues when it comes to paying doctors in time as well as medical practices getting the revenue they generate in full.

This begs for there being in place effective strategies and insights that will help medical practitioners and health centers to improve their patient billing processes. This will help them generate more revenue as well as increase their healthcare reimbursements.

Use of Technology

Whenever a medical practice realizes that a claim is not paid for when they submit the claim for the first time, they should brace themselves that it will not be paid. In order to escape losing out on claims like this, the practice has to find ways that will help it establish potential denials before even submitting their claims. Medical practices could be able to achieve this feat by incorporating software in their systems that is capable of identifying claims with a high probability of being denied automatically.

This billing software utilizes an engine that is intelligent and one that adapts and updates itself constantly thus helping practices to stay informed and alert about denial trends that are latest in as far as claims are concerned. This will greatly improve the rates at which practices collect their revenue. This software is generally able to help the practices improve on the speed at which they collect, decrease the need of having in-house staff as well as increase first pass resolution rates.

Tackling Underpayments

Payer underpayments are another issue that keeps medical practices from collecting their full amounts of revenue. This is largely due to the different individual contracts doctors often enter into with different payers. Underpayments are far too common in situations for health center billing, specifically federally qualified health center billing (FQHC billing), as these community health centers are focal to serving low income patients who utilized Medicare and Medicaid.

This is the key reason why medical practices receive different amount of monies from the different payers. This makes it hard for the practice to keep track of the payments and hence making it even harder for them to realize when they are being underpaid.

It is for this reason that practices ought to turn to using medical billing software that is able to compare the payments it is receiving against the figures agreed to in the contracts automatically. This will largely cut short the number of payer underpayments scenarios. It will also increase the net collection rates, increase organization and efficiency of the practice and make it possible for the practice to forecast its collections in future.

Reporting

In order for a medical practice to realize its position as far as payer payments and collection rates are and the areas that need an improvement, reporting ought to be embraced. This can be done with software that is capable of allowing scheduled reports on the practice to be done at defined intervals.

This will give the practice the opportunity to have certain reports in an instant whenever it is needed. These reports make decision making easier, increase productivity (as it reduces staff requirements and make it easier to spot payer underpayments and other mistakes.

All the above solutions will ensure that your practice is able to collect more revenue thereby turning them into more revenue generating practices. They will also ensure that the practice increases its healthcare reimbursements. It also makes the collection of monies owed to the practice easy, fast and efficient.

For more quality information on how medical practices and health centers can improve healthcare reimbursements, visit MaximizedRevenue.com