Why FQHCs Are Faced Greater Challenges With Medical Billing

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Federally Qualified Health Centers, or FQHCs, have been a major backbone of the health care system in the country for more than half a century. They are more popularly known as Community Health Centers or Neighborhood Health Centers and are part of the “war on poverty.” billing challenges with FQHCs

These centers have treated more than 21.1 million patients as of 2012 and have been providing quality primary health care and comprehensive treatment options to those who are unable to afford expensive treatment at hospitals. FQHCs focus on both primary and preventive care; this treats the people in the community if they happen to get illnesses while also promoting health so as to avoid getting sick in the first place.

FQHCs are a very important part of the health care safety net as they accept patients regardless of their ability to pay even if they don’t have health insurances. However, because of this, the FQHC also faces problems, especially with medical billing and receiving payments from the patients.

The Challenge FQHCs Face With Patient Billing

As these health centers cater to the impoverished population, it is required to use a sliding fee scale which is based on the family size of the patient, income based on the federal poverty guidelines as well as other criteria. The FQHCs receive grants under Section 330 of the Public Health Service Act but it isn’t enough to maintain operational costs.

This is largely because most patients who visit the center really have no money to pay for services. As a whole, most FQHCs only get around 75%, or the health center’s insurance billing and collection. This is a very big issue as revenue cycle is the lifeblood of these health centers since it is the one driving the growth while also increasing their access to quality care and expert consultants.

The Solution for Better FQHC Billing Systems

There are many possible solutions to the problem; one such solution is through hiring a third-party health center billing company to handle the billings and collection. Looking for qualified FQHC billing experts can be a bit difficult but it is important as these companies handle the revenue cycle management extremely well. They solve the problem by looking at all the business processes in the center and ensure that the revenue cycle is at its maximum efficiency.

Another reason for lower collections can mostly be attributed to staff turnover, clearinghouse issues, and misconfigured billing programs. This is also solved by outsourcing this to industry experts in FQHC billing. Account receivables are time consuming and complicated and are often put on hold which becomes lost income for the center; instead of going back to the revenue cycle, they are put on hold until they are collected. This means that whatever potential that amount could have brought to the cycle is lost as well.

Catering to the impoverished is a noble and worthy cause; however, to give the best kind of service, it is important to optimize expenses. Since the FQHC is catering to people who have very little to begin with, it is now up to the management to make do with what they have and still deliver the best possible health care that they can give.

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