FQHC Billing Services
NextGen Billing Solution simplifies the complexities of billing for safety-net providers, helping manage diverse patient populations, navigate intricate billing codes, and maintain compliance with federal and state regulations. With specialized FQHC billing services, NextGen Billing Solution ensures accurate claims, reduces denials, and can increase revenue by up to 35%. Let NextGen Billing Solution take care of the billing challenges so your team can focus on delivering essential care to your community.
Why Should You Outsource FQHC Billing?
Federally Qualified Health Centers (FQHCs) offer a diverse range of services and employ many types of medical professionals, which makes medical billing particularly complex. Accurate coding must adhere strictly to the Centers for Medicare & Medicaid Services (CMS) regulations specific to FQHCs, making it highly beneficial to work with experts in medical billing and revenue cycle management (RCM).NextGen Billing Solution has been refined through years of experience, enabling us to help clients increase revenue reliably. We meticulously review claims for errors before submission, follow each payer or clearinghouse’s requirements, and track every claim until it is fully paid. Denials are followed up on promptly at no extra cost, and challenging claims are never left unresolved. NextGen Billing Solution delivers comprehensive billing services that optimize your center’s revenue while simplifying the entire revenue cycle.
Experienced and HIPAA Compliant
Because FQHCs provide a wide range of services, it can be challenging for medical staff to stay updated on all the correct billing codes—especially since Medicare codes are often complex. NextGen Billing Solution offers certified coders and billers with specialized experience in FQHC billing services. Each team member is also trained in HIPAA best practices, ensuring patient information is managed securely and your organization stays fully compliant.
The Challenges of Medical Billing for FQHCs
FQHCs serve a diverse patient population with a wide range of healthcare needs, which requires coders and billers to be proficient in multiple coding systems. A NextGen Billing Solution can streamline this process, ensuring accuracy and efficiency. Here are a few reasons why billing for these facilities can be particularly complex:
Per-Diem Payments
NextGen Billing Solution, if a patient has multiple visits with the same FQHC practitioner on a single day, these visits must generally be billed as a single encounter. Exceptions include a qualified mental health visit combined with a medical visit, or if the second visit requires a separate diagnosis—such as being treated for an illness and returning later the same day for an injury. Billers using NextGen Billing Solution are trained to carefully track the purpose of each visit and ensure that separate claims are submitted only when exceptions apply. training ensures our billing team stays up to date with the specific requirements of each specialty or healthcare organization.
Off-Site Visits
Qualified FQHC visits can occur not only at approved facilities but also at a patient’s home, a Skilled Nursing Facility (if covered by Medicare Part A), or even at the scene of an accident. Accurate coding for these scenarios requires careful documentation of medical necessity and location. NextGen Billing Solution provides advanced billing software and training tools that keep billers up to date on these requirements, including variations across different states.
Mental Health and Substance Abuse Coverage
In addition to standard medical visits, FQHCs often offer behavioral health services and psychiatric consultations. Utilizing NextGen Billing Solution ensures that medical coders and billers are fully equipped to handle these specialized services while staying compliant with CMS guidelines for each type of visit.
NextGen Billing Solution Boosts Payer Reimbursement and Ensures Seamless Revenue Cycle Management
Our Software Assures Use of the Current Codes
Our NextGen Billing Solution revolutionizes FQHC billing by leveraging advanced software that ensures coders always use the most accurate and up-to-date codes. From the moment a patient schedules an appointment, it manages the entire billing cycle efficiently, guiding each claim seamlessly through submission to final payment.
Revenue Cycle Management from Start to Finish
In addition to providing a skilled team of medical billing specialists to manage claims, NextGen Billing Solution offers a comprehensive range of revenue cycle management services. From payer credentialing and compliance audits to coverage verification and annual payer reconciliations, we help streamline your workflow, reduce administrative burdens, and support exceptional patient care.
NextGen Billing Solution helps increase revenue while reducing the stress of managing complex billing processes. With our expertise, your FQHC can focus on patient care without worrying about claims and coding. Contact us today to see how NextGen Billing Solution can support your practice’s success.Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.