3 Ways FQHCs Can Optimize Revenue Streams & Improve Financial Health

FQHC health centerFederally qualified health centers (FQHCs) are organizations that receive grants, and in most cases under the Public Health Act. Most of these health centers serve the underserved areas of the population, offering a sliding fee scale and providing comprehensive services.

Maintaining the revenue of a health organization is far more complex than what most people expect. In the FQHCs, there are various departments that need to work and collaborate efficiently in order to maximize the revenue from the patients’ billings.

These health centers seek to improve revenue, but they are highly challenged by their static and the declining patient volumes, the regulatory framework, and their patient case reclassifications. These health centers should focus on the below discussed proven methods in order to optimize their billing processes, revenue streams, and improve the financial health.

1. Understand the overall cycle of the revenue

It is an accepted healthy practice to have a clear understanding of the overall cycle that is used in the revenue collection in order to optimize the revenue streams. There should be a clear billing process that starts when a patient books an appointment and ends when the patient has been attended to after the payments have been done.

An FQHC should this establish a clearly structured billing strategy that caters for the patient registration, the charge entry, the payment posting and a follow up in the accounts receivable.

health center medical app2. Capture all charges and review and update the fee schedules

During the FQHC billing process, staff should collect and enter all the accurate information in regard to demographics and the insurance concerning a particular patient. These health centers should have the insurance information, the telephone numbers, the birth dates and the home address to facilitate effective billing.

To optimize the revenue collection, the health centers should reconcile the encounter forms and the health schedules for every day. The FQHCs should be able to track the encounter forms that may be missing and thus down all possible avenues for loss of revenue.

3. Reduce out-of-network revenue leakage

doctor shaking handsMost of the health systems are known to have aggressively hired physicians. Beyond this hiring, incremental salaries and office related infrastructure expenses burden the income statements. Health centers should not acquire physician practices and services without the appropriate steps to limiting and preventing out-of-network referrals that happen to the competitors. The health centers should this optimize the practice efficiency.

FQHCs should make use of vendor applications that provide advanced clinical documentation features that coordinate proper care across a clinically integrated network, to properly track and shape patient referrals and scheduling. Making use of these web-based vendor applications are a bit inexpensive, easy and fast to implement and properly integrate with existing workflows and technologies for better service delivery and optimization

In order to optimize and maximize FQHC revenue streams, these health centers should clearly communicate to patients on its billing and financial policies. There should be documents that are signed by each patient and well placed in the files. The document should explain the terms of payment, any authorization mechanisms, insurance information and the collection or cancellation of the institution’s policies.

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