Print Page   |   Contact Us   |   Sign In   |   Register
Billing & Finance Resources
Share |

The resources on this page are organized by presentations (archived videos, slidecasts, and PowerPoints),  resource documents (Medicare, Medicaid and HRSA reports, issue briefs, fact sheets, websites), and miscellaneous tools and templates. If you don't find what you are looking for you can search by keyword using the search field at the top of this page.

 

Presentations

Understanding HRSA's 19 Program Requirements
2013 | PDF | Source: Holton Healthcare Consulting, Inc.
An overview of HRSA's operational assessment.
Presented at May 2013 Joint Meeting of the MPCA Finance and Billing Networks


Establishing & Refining Fee Schedules

2013 | PDF | Source: Michigan Primary Care Association
What are the rules and how do other Health Centers approach the process?
Presented at May 2013 Joint Meeting of the MPCA Finance and Billing Networks


Medicaid MOA Update & Payment Reform

2013 | PDF | Source: Michigan Primary Care Association
Where we are today, developing a vision for the future.
Presented at May 2013 Joint Meeting of the MPCA Finance and Billing Networks

 

Resource Documents

Medicare FQHC Resources
Website | Source: Centers for Medicare & Medicaid Services

Medicare Resources: Enrollment

National Plan and Provider Enumeration System (NPPES) (NPI)
2015 | Website | Source: Centers for Medicare & Medicaid Services
Health Centers must obtain a National Provider Identifier (NPI) to appropriately bill for services.

Medicare Enrollment Application-Institutional Providers (CMS 855A Enrollment Form)

2016 | PDF | Source: Centers for Medicare & Medicaid Services

Each Health Center site must file this form to initiate and maintain reimbursement under the FQHC benefit.

Medicare Enrollment Application-Physicians and Non-Physician Practitioners (CMS 8551 Enrollment Form)

2016 | Website | Source: Centers for Medicare & Medicaid Services

Physicians and non-physician practitioners can apply for enrollment in the Medicare program or make a change in their enrollment information using the Internet-based Provider Enrollment, Chain and Ownership System (PECOS).


The Basics of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) for Provider and Supplier Organizations 

2015 | PDF | Source: Department of Health & Human Services, Centers for Medicare & Medicaid Services
Helpful tool that provides basic information on registering providers using Provider Enrollment, Chain and Ownership System (PECOS) CMS Website

Process for Becoming Eligible for Medicare Reimbursement Under the FQHC Benefit
2015 | Website | Source: Bureau of Primary Health Care
Program Assistance Letter 2011-04 highlighting the steps that Health Centers must take in order to initiate and maintain reimbursement by Medicare under the FQHC benefit.

National Plan and Provider Enumeration System (NPPES) (NPI)
2015 | Website | Source: Centers for Medicare & Medicaid Services
Health Centers must obtain a National Provider Identifier (NPI) to appropriately bill for services.

Medicare Enrollment/Revalidation Cycle 2
PDF | Source: Department of Health & Human Services

  

Medicaid and 340B: What Health Centers Need To Do

PDF I Source: Michigan Primary Care Association

 

Medicare Resources: Reimbursement

Process for Becoming Eligible for Medicare Reimbursement Under the FQHC Benefit
2015 | Website | Source: Bureau of Primary Health Care
Program Assistance Letter 2011-04 highlighting the steps that Health Centers must take in order to initiate and maintain reimbursement by Medicare under the FQHC benefit.

RHC/FQHC Billing Guide
   
Provides billing information for both RHC’s and FQHC’s.

Medicare Secondary Payer Billing Guide
2015 | PDF | Source: Centers for Medicaid & Medicare Services  

Medicare Secondary Payer Billing Guide

2015 | PDF | Source:  for Medicaid & Medicare Services  


Scenarios and Coding Instructions for Submitting Requests to Reopen Claims Beyond the Claim Filing Timeframes

2015 | PDF | Source: Centers for Medicaid & Medicare Services  

Medicare Immunization Billing Grid
2015 | PDF | Source: Centers for Medicaid & Medicare Services 

Medicare Billing for Federally Qualified Health Centers
2014 | PDF | Source: Centers for Medicare & Medicaid Services
Questions and answers of FQHC Medicare billing.

 

Chronic Care Management 2016 
Provides information on new Chronic Care Management documentation and billing requirements.

Chronic Care Management Fact Sheet 2016  
Fact Sheet describing requirements.

 

Chronic Care Management FAQ’s  
Frequently asked questions related to Chronic Care Management

Prospective Payment System (PPS) 2016

 

Specific Qualified Payment Codes 2016

Provides a list of qualifying visit codes and corresponding PPS G codes.

 

Prospective Payment System FAQ’s
List of frequently asked questions related to PPS billing.

 

Preventative Services Chart 2016

Information on preventative services as it relates to FQHC’s

 

Medicare Learning Network

2016 | Website | Source: Centers for Medicare & Medical Services

National articles designed to inform Medicare fee-for-service providers about the latest changes to the Medicare Program. Subscribe to Medicare MLN Connects Provider E News

 

Medicare for Michigan & Indiana Providers  

2015 | Website | Source: WPS Health Insurance


Medicaid Resources
 

Medicaid FQHC Resources
Website | Source: Michigan Department of Health & Human Services

Michigan Medicaid State Plan
2015 | Website | Source: Michigan Department of Health & Human Services
Details all Medicaid covered services in Michigan.

Vaccines for Children Program
2015 | Website | Source: Centers for Disease Control & Prevention
Vaccines for Children (VFC) program Q&A including information on vaccine administration fees.

 

Vaccines for Children Program - Michigan
2015 | Website | Source: Michigan Department of Health & Human Services
Vaccines for Children (VFC) program Q&A including information on vaccine administration fees.

CHAMPS: Michigan Medicaid Processing System
Website | Source: Michigan Department of Health & Human Services
Michigan Health Centers must enroll using CHAMPS to receive reimbursement from Medicaid.

MI Health Link Contact List for Provider Contracts

2015 | PDF | Source: Michigan Department of Health & Human Services

 

Health Resources and Services Administration Resources

 

Sliding Fee Schedule Board Document

2015 | PDF | Source: National Association of Community Health Centers

 

Discounted Fee Schedule

2015 | Website | Source: National Health Service Corps 

Sliding Fee PIN 2014-2
2014 | PDF | Source: Health Resources and Services Administration
HRSA defines program requirements as it relates to the sliding/discount fees

Sliding Fee Pin 201-02 FAQ's
PDF | Source: Health Resources and Services Administration

Integrated Care Billing Worksheet
2015 | PDF | Source: Substance Abuse and Mental Health Services Administration
Worksheet on financing and billing integrated care in Michigan.

Health Center Program Site Visit Guide
Website | Source: Health Resources and Services Administration

Health Center Management & Finance
2015 | Website | Bureau of Primary Health Care
Includes applicable policy and program assistance letters related to Health Center finance, legal issues, public coverage programs and scope of project. 

Identifying the Risks of Health Center Failure: A Guide for Health Centers
2014 | PDF | Source: Capital Link
Examines the differences between failed or failing Health Centers and their more successful counterparts offering Health Centers a better understanding of what operational and financial issues have resulted in financial stress for other Centers and impacted their ability to stay in business.  


Miscellaneous

Federally Qualified Health Center Fact Sheet
2015 | PDF | Source: Centers for Medicare & Medicaid Services
Provides general guidance on covered FQHC services.

Financial Growth Benchmark Tool - coming soon!

 




 

 
Association Management Software Powered by YourMembership.com®  ::  Legal