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Medical Billing for FQHC

FQHC Billing Services

Protect your health center with automated sliding fee scales, 340B compliance, and expert UDS reporting. We synchronize your clinical mission with federal financial standards to ensure every encounter is captured.

0.4%

First-Pass Acceptance Rate

<0

Days Wrap-Around Recovery

0%

UDS Audit-Ready Accuracy

Our Services

Comprehensive FQHC Revenue Cycle Management

PPS & APM Rate Mastery

We specialize in the 2026 Prospective Payment System, ensuring every encounter is billed at the maximum allowable rate. This includes accurately capturing the higher PPS rate for new patients versus established patients—a frequent source of revenue leakage for community health centers.

Sliding Fee Scale Compliance

Our systems automate sliding fee scales based on the current Federal Poverty Guidelines, protecting your center from HRSA audit findings and maintaining your 330 Grant eligibility.

340B Drug Program Coordination

We manage the complex billing interactions between your pharmacy program and FQHC status. Our team mitigates duplicate-discount risks and ensures compliance with GPO prohibitions, protecting your “covered entity” status.

Wrap-Around Payment Recovery

We aggressively pursue state-specific Medicaid wrap-around payments. Using a specialized tracking ledger, we reconcile the difference between MCO payments and your full PPS reimbursement rate to maximize cash flow.

UDS & HRSA Reporting

We simplify your annual Uniform Data System (UDS) reporting by ensuring all financial data and encounter codes are mapped correctly for seamless federal submission.

SDOH & Encounter Coding

Expert coding for Social Determinants of Health (SDOH) ensures patient complexity is fully documented. By utilizing specific Z-codes, we justify higher reimbursement & support future grant allocations.

Why Outsource

The Revix MD Advantage: Why Outsource?

Transition from administrative burden to community-focused care with a specialized FQHC billing company.

Reduced Administrative Overhead

Eliminate the high costs of in-house billing staff, benefits, and training. Our variable-cost model aligns your expenses directly with your actual collections.

Guaranteed HRSA Compliance

We mitigate audit risks by automating your sliding fee scale and ensuring all billed services remain strictly within your approved HRSA Scope of Project.

Real-Time Financial Visibility

Access transparent RCM dashboards to monitor your encounter capture, denial rates, and provider performance across all multi-site health center locations.

Getting Started

Your Path to Financial Stability: 30-Day Onboarding

WEEK 1

Discovery & Audit

We analyze your current PPS capture and identify wrap-around payment lags.

WEEK 2

System Integration

Seamless API or clearinghouse synchronization with your existing EHR.

WEEK 3

Coding Alignment

We train your staff on 2026 G-code bundles, SDOH Z-codes, and new vs established patient documentation.

WEEK 4

Go-Live

Full-cycle billing begins with daily claim scrubbing and real-time denial management.

Client Success

Client Success Stories

On Grant Compliance

Revix MD ensured our Sliding Fee Scale was 100% HRSA compliant. Their expertise protected our 330 Grant funding during a rigorous site visit and audit.

CEO

Urban Community Health Center

On PPS Reimbursement

Our PPS rate capture increased by 15% after switching. They finally fixed our wrap-around payment delays, significantly improving our monthly cash flow and financial stability.

CFO

Rural Health Clinic Group

On Reporting Accuracy

UDS reporting used to be a nightmare for our staff. With Revix MD, the data is clean, mapped correctly, and ready for federal submission instantly.

Director of Finance

Multi-Site FQHC

Get Started

Ready to Modernize Your FQHC Revenue Cycle?

Schedule a Consultation
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FAQs

Our seamless onboarding process typically takes seven to ten business days. We integrate directly with your existing EHR to ensure zero interruption to your cash flow.

We maintain a 98.8% first-pass clean claim rate by utilizing advanced AI-scrubbing technology that catches technical and clinical errors before they ever reach the payer.

We implement strict documentation reviews and automated triggers to ensure all “incident-to” and split/shared visits meet CMS requirements, maximizing reimbursement while ensuring total audit protection.

Yes. Our CMRS-certified specialists have expertise across 25+ specialties. We assign dedicated coding pods to match your specific specialty mix for maximum accuracy and yield.

We use a variable-cost model based on collections. This eliminates fixed salaries and benefits, typically reducing your total billing overhead by up to fifty percent.