There are several reasons FQHC’s are not capturing the full PPS rate for given services including credentialling issues, code capture, and classifying revenue codes appropriately. Practices also may not receive a full PPS rate because of Medicare Advantage Plans that are not contracted to reimburse at the PPS rate or incorrect forms submissions.
In most practices, shortfalls can go undetected because many practices do not have the expertise to uncover and therefore resolve issues. Leaving money on the table has also become even more prevalent with the expanded adoption of Telehealth visits and the complexities of billing in this environment.
At RCM360, it’s our sole focus to help practices gain the insight they need to stop leaving money on the table. Schedule an accounts receivable analysis. In just 30 minutes you could gain the visibility you need to take action and be better prepared for the future. Click here to schedule a call.