Revenue Cycle Management

93 percent of Federally Qualified Health Centers (FQHCs) employ their own billing staff to collect payments from Medicare, Medicaid, and a host of private, commercial payers. The average collection rate (as a percentage of net-charges) for these in-house billing operations is 71.4 percent. This translates to a 50% gross collection rate of top line invoicing.

The average community health center is receiving only .50 for each $1 billed to insurance.

One of the factors impacting health center cash flow is that FQHC billing is quite different from all other types of billing. It involves a unique blend of special payment rates, different claim formats, and unique payer requirements. Even an experienced billing professional must receive specialized training to be proficient with FQHC billing requirements.

Most FQHC billing departments are significantly understaffed.

Your billing department should have approximately 1 FTE per 10,000 annual claims

Revenue Cycle Management

Another factor impacting FQHC billing is that FQHC central billing offices (CBO) are often understaffed or poorly organized. Since the healthcare revenue cycle is a series of business processes it is important that there are KPIs and measurement systems that allow for monitoring performance and results. “FQHC should be monitoring more than just has A/R gone up or down and how many denials do we have.” comments Synergy’s CEO M. Jayson Meyer, “The more effective a health center is at collecting on billed charges the more revenue that falls straight to the bottom line.”

It’s true, and even during a Pandemic, Synergy Billing returned $38 million of additional net revenue to clients above the national norms to FQHC clients through effective revenue cycle management. Even during difficult business conditions, Synergy Billing RCM clients experienced a collection rate of more than 95 percent vs. 71.4% (national average). That is highly motivating and quite possible for any FQHC that is committed to financial and operational excellence.

You can engage Synergy Billing to optimize your existing revenue cycle operations or to provide a helping hand with day-to-day revenue cycle processes.

Optimizing Your Revenue Cycle Begins By Optimizing Several Key Areas & Business Processes

Working In Synergy Will Lead To Improvement In These Key Areas

Contact Us. Revenue Cycle Management

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