The billing process for Federally Qualified Health Centers (FQHC) and Community Health Centers (CHC) is unique and complex. Community health centers face a number of billing challenges such as accepting minimum payments, sliding fee schedules, county programs and payment plans.
MEDCOR understands the uniqueness of FQHC billing and is expert at the following:
- Medicare PPS rate
- Medi-Medi, Cal-Optima
- Code 1, Medicaid, Medi-Cal Programs
- Code 2, Medicare and crossover claims
- Code 3, 11 & 12
- Code 18, (wrap payments), Managed Care (Cap)
- Code 20 Medicare Advantage
- CDP, FPACT, CHDP, CPSP
- Prop 10, CSR programs
- PPS rates, sliding scale/self-pay, share of cost and split billing
- Dental billing, Healthy Smiles
- LCSW, Behavioral Health, Beacon
- Ancillary billing such as Chiropractic, Optometry, Podiatry
- LA CARE – Preferred IPA
- Healthcare Partners/PA
- Allied Physicians / PIPA
- Cal Optima – MSI/MSN
- Monarch-Prospect_CHOC HA
- ADOC- Talbert-GNP
- IEHP-Central Health
- Northern CA/Partnership
- NYS Public Health Plans
- UDS & Cost Reporting
- Medi-Cal & CMS Coding Audits
- Provider Productivity Benchmarking
- Metrics and Dashboards
- Financial end-of-month data sets
UDS reporting and cost reporting available through our affiliate partners.
Transitioning from Pro Bono care to a business model is often difficult and requires experience and understanding of those specific transitional requirements including cultural shift, Information Technology integration and work flow processes. MEDCOR’s strength in this transitional experience is critical to your success.
FQHC specific software platforms
MEDCOR is experienced with a variety of EHR/EMR software platforms. Click here to see the complete list.