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.