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Billing specialists processing invoices for Federally Qualified Health Center (FQHC) services in an office setting.

FQHC Billing Services

Billing and RCM Services Tailored for Federally Qualified Health Centers.

Why Should You Outsource FQHC Billing?

Federally Qualified Health Centers (FQHCs) offer a wide array of services and employ diverse medical professionals, resulting in complex medical billing. Compliance with the specific coding rules outlined by the Centers for Medicare & Medicaid Services (CMS) for FQHC-designated facilities is crucial. Thus, outsourcing coding and billing to specialists in medical billing and revenue cycle management (RCM) has proven highly advantageous.

Our system, refined over a decade, ensures that our services boost our clients’ revenue. We meticulously review claims for errors before submission, tailor submissions to each payer or clearinghouse’s requirements, and diligently track claims until they are paid. We also provide follow-up on denials at no extra cost, never leaving a challenging claim unattended. WeCare offers billing services that optimize your center’s income and streamline the entire revenue cycle.


Experienced and HIPAA Compliant

Given the wide range of services offered by FQHCs and the complexity of Medicare codes, it’s challenging for medical staff to stay current on all the correct codes. WeCare offers certified coders and billers with specific experience in FQHC billing services. Furthermore, all our employees are trained in HIPAA best practices to guarantee the secure handling of patient information and maintain your organization’s compliance.

Per-Diem Payments

When a patient has multiple visits with an FQHC practitioner on the same day, they should typically be billed as a single visit. Exceptions include cases like a qualified mental health visit and a medical visit on the same day, or when the second visit involves a distinct diagnosis (e.g., one visit for an illness and a separate one later that day for an injury). Billers must be vigilant in understanding the nature of each visit to avoid submitting separate bills if neither exception applies. Our billers undergo continuous training to ensure they are well-versed in the specific requirements of each specialty or organization they serve.

Medical Counter
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Off-Site Visits

Qualified FQHC visits can occur not only at approved facilities but also at the patient’s residence, a Skilled Nursing Facility (if covered by Medicare Part A), or even the site of an accident. Accurate coding in these scenarios requires meticulous documentation of medical necessity and location. WeCare’s medical billing software and training system keep our billers informed about these specific requirements, including any variations that may exist from state to state.

Mental Health and Substance Abuse Coverage

In addition to medical visits, FQHCs may offer behavioral health care management and psychiatric consultation services. Medical coders and billers must be well-versed in these additional specializations and understand the CMS expectations for each type of visit.


WeCare Increases Payer Reimbursement and Assures Smooth RCM


Our Software Assures Use of the Current Codes

Our innovative approach to FQHC billing services begins with our proprietary software, which ensures coders have access to the correct codes, including the latest updates. It manages the billing cycle from the moment the patient schedules an appointment and streamlines the entire process until the claim is successfully paid.


Revenue Cycle Management from Start to Finish

In addition to our expert medical billers, we provide a comprehensive suite of RCM services. This includes payer credentialing, compliance reviews, coverage verification, annual payer adjustments, and payback, all aimed at streamlining your workflow and ensuring excellent patient care.

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