At Invicta MD, we specialize in providing medical billing and revenue cycle management (RCM) services tailored to the unique needs of Federally Qualified Health Centers (FQHCs). We understand the complexities of FQHC billing, including the requirement to comply with specific government regulations, the need for accurate coding, and the challenges of dealing with multiple payer sources.
Federally Qualified Health Centers (FQHCs) offer diverse services and employ various medical professionals, making medical billing complex. FQHC billing must adhere to the Centers for Medicare & Medicaid Services (CMS) specific regulations requiring precise coding and documentation. Outsourcing billing to professionals who specialize in medical billing and revenue cycle management (RCM) ensures accuracy and efficiency.
At Invicta MD, our billing system has been perfected for over a decade, guaranteeing increased revenue for our clients. We carefully “scrub” claims for errors before submission, follow payer and clearinghouse-specific guidelines and track each claim through to payment. We handle denials at no extra cost, ensuring no claim is left unresolved.
FQHCs deliver a wide range of services, which makes it challenging for medical staff to keep up with all the correct and current codes, especially with the complexities of Medicare. Invicta MD provides certified and experienced coders and billers specialising in FQHC billing services. Every team member is also trained in HIPAA best practices, ensuring that your patient data is securely handled and your organization remains fully compliant.
FQHCs have many patients with a wide variety of needs, which means coders and billers must be experienced with many different codes. The following are just a few of the reasons billing for this kind of medical facility can be so complex:
When a patient visits an FQHC practitioner multiple times a day, those visits must be billed as a single visit unless they involve a qualified mental health visit or a medical visit with a different diagnosis (e.g., a medical issue and an injury on the same day). Billers must carefully assess each visit and avoid submitting separate bills unless one of these exceptions applies. At Invicta MD, our billers undergo continuous training to stay up-to-date with the specific requirements of each speciality and organization we serve, ensuring accuracy in every claim.
FQHC visits can occur at various locations, including a patient’s home, a Skilled Nursing Facility (if covered by Medicare Part A), or even at the scene of an accident. Proper coding for these visits requires careful medical necessity and location documentation. At Invicta MD, our advanced billing software and continuous training ensure that our billers stay informed of the specific requirements, including state-to-state variations, to guarantee accurate claims every time.
FQHCs may also offer behavioural health care management, psychiatric consultations, and medical visits. Medical coders and billers at Invicta MD are well-versed in the CMS requirements for these specialized visits and understand the nuances of coding for mental health and substance abuse services. This expertise ensures that every claim is accurate and compliant with the latest standards.
Invicta MD’s innovative approach to FQHC billing services begins with our proprietary software, ensuring that coders always have the most up-to-date codes. From the moment a patient schedules an appointment, our software streamlines the entire billing cycle, managing everything seamlessly until the claim is successfully paid.
In addition to our expert team of medical billers handling claims, Invicta MD offers a comprehensive suite of RCM services. From payer credentialing and compliance reviews to coverage verification, annual payer adjustments, and payback, we ensure your workflow runs smoothly and support excellent patient care at every step.
