Federally Qualified Health Centers

By reviewing the revenue cycle process, Granite GRC will help identify areas of opportunity within the revenue cycle process. Lack of resources and limited funding have put a strain on the day-to-day operations of the FQHC. By identifying gaps within the revenue cycle process, from registration through patient collections, GGRC can help improve the efficiency and effectiveness of the FQHC recapture.

Addressing Needs and Challenges

Granite GRCs team of professionals can help meet the revenue cycle challenges unique to the FQHC. Working with the FQHC team, GGRC will optimize processes and procedures to ensure compliance with the regulations unique to this place of service.

 

• Registration: The most important piece of the revenue cycle is the complete and appropriate capture of initiating the patient’s demographics and insurance information.
• Insurance Eligibility Checks: Once the insurance has been identified, understanding the patient’s benefits prior to services ensures proper reimbursement for the FQHC and peace of mind for the patient about upcoming charges.
• Documentation and Coding: Documentation must support the appropriate coding, and coding must be accurately performed to capture and hold proper reimbursement. A thorough look at this process ensures that payor rules are being followed.
• Charges: Timely charge entry is integral to timely reimbursement, as well as preventing denials due to untimely filing.
• Claims Review: Ensuring that clean claims go out the door the first time is essential in today’s revenue cycle.
• Timely Submission: This can only be accomplished through timely charge entry and claims review. Identifying any blockers to this process is key in understanding your revenue cycle practice.
• Collections: Identifying proper reimbursement is key to the ongoing existence of the FHQC. Review of payment contracts from payers is essential, as well as ensuring patient copays and deductibles as well as personal payments are collected in a timely manner.