Maintaining the revenue of a health or medical practice is far more complex than most people expect. In Federally Qualified Health Centers (FQHCs), there are different departments that need to work efficiently in order to maximize revenue from patient billings.
FQHCs should therefore implement effective billing policies and procedures, while applying strategies in order to lower costs, increase revenue, and improve patient satisfaction and care. To maximize revenue, FQHCs can apply the following patient billing strategies.
Having a clear understanding of the overall cycle of revenue is very important in improving FQHC billing processes so that they function effectively. Many health facilities consider the submission and the subsequent payment of claims as the actual billing process when actually all the staff members in the health center play a very vital role.
Billing should begin when a patient books an appointment and end once the patient has been attended to and makes the payments. A FQHC should therefore establish proper billing process channels that include patient registration, charge entry, payment posting and the follow up on accounts receivable.
It is very critical during the FQHC billing process that the staff collect and enter accurate information regarding demographics and insurance once the patient visits the health center. For first time patients, the health center should have their insurance information, birth dates, telephone numbers and home addresses for effective billing. If the patients have been treated in the health facility before, the receptionist should ensure that the information is accurate upon the arrival of the patient.
Another strategy for improving FQHC billing for maximized revenue is by reconciling encounter forms with appointment schedules every day. This ensures that for each patient that gets attended to, a charge corresponds. The sum of the charges on the encounter forms must then be reconciled daily in the reports that the management system generates.
By doing this, the health facility should be able to track encounter forms that might be missing, hence ensuring that revenue is maximized. This FQHC billing strategy will help prevent the loss of revenue through nursing home and health center visits. One way of capturing all charges is by using preprinted index cards that physicians carry.
FQHC should ensure that they update their fee schedules annually. To maximize revenue, realistic charges should be set for all codes. By so doing, it will ensure that all reimbursements are achieved. The fees charged should be compared with other contracted or Medicare fees charged by health center billing services. Insurance companies tend to pay lower than the contracted or billed amount. This means that billing lower than the amount contracted will result in the health facility losing revenue.
In order to maximize revenue, a FQHC should communicate to all the patients its billing and financial policies. It could use, for instance, a single page document that summarizes its financial policies.
This document should then be signed by each patient and placed inside his file. The document should explain the terms of payments, authorizations, and insurance information, collection and cancelation policies. There are more strategies to imporve medical billing procedures for FQHCs, but start with these strategies to get an established system in place that will keep your FQHC financially healthy.
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