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 (reports, issue briefs, fact sheets, websites), and tools and templates (spreadsheets, modifiable Word documents, job descriptions). 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

 

4 Uniform Grant Guidance Requirements

2014 | PDF | Source: Brian Dixon, CPA, Yeo & Yeo, PC
Presented at December 2014 MPCA Finance Network Meeting  


Top Audit Issues in FQHCs

2013 | PDF | Source: Brian Dixon, CPA, Yeo & Yeo, PC
Presented at December 2013 MPCA Finance Network Meeting


Cost & Productivity Benchmarking

2013 | PDF | Source: Michigan Primary Care Association
Recent data perspectives and discussion.
Presented at December 2013 MPCA Finance Network Meeting

 

Instructions for Pulling Reconciliation Data from CHAMPS
2013 | PDF | Source: Michigan Department of Community Health
Presented at December 2013 MPCA Finance Network Meeting

 

The Next Wave of Employer Benefits
2013 | PDF | Source: Saginaw Bay Underwriters
Defined contribution, private exchanges and other health Insurance Updates
Presented at December 2013 MPCA Finance Network Meeting


Maximizing Collections

2013  |  PDF  |  Source: Holton Healthcare Consulting, Inc.
Presented at May 2013 Joint Meeting of the MPCA Finance and Billing Networks


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


Preparing for ICD-10 CM: Effects & Expectations

2013 | PDF | Source: Hank Mayers, MCP, PMP, CPHIMS, ReliaTech Consulting, LLC
Presented at May 2013 Joint Meeting of the MPCA Finance and Billing Networks


ICD-10: Conducting the Technology & Practice Impact Assessment

2013 | PDF | Source: Hank Mayers, MCP, PMP, CPHIMS, ReliaTech Consulting, LLC
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


Finance: A Guide to Safety Net Provider Reimbursement

2013 | PDF | Source: Health Management Associates
Presented at May 2013 Joint Meeting of the MPCA Finance and Billing Networks


Health Center Audit & UDS Financial Analysis

2013 | PDF | Source: Michigan Primary Care Association
Presented at May 2013 Joint Meeting of the MPCA Finance and Billing Networks


2013 Financial Analysis Data Sheet

2013 | PDF | Source: Michigan Primary Care Association
Presented at May 2013 Joint Meeting of the MPCA Finance and Billing Networks

 

Utilization and Healthcare Needs Amongst Newly Eligible for Coverage Populations
2013 | PDF | Source: Michigan Primary Care Association
Presented at May 2013 Joint Meeting of the MPCA Finance and Billing Networks

  

Aligning Payment with Patient-Centered Care and Value-Based Pay
2013 | PDF | Source: Craig Hostetler, Oregon Primary Care Association
Oregon has recently implemented an alternative payment methodology (APM) for Health Centers that removes the incentive to produce F2F visit with a billable provider to bring in revenue to the clinics. The hope is that it will enable the Health Centers implementing Oregon’s APM to provide better care and align them with the value-based pay incentives that the current health care environment is demanding.
Presented at the 2013 MPCA Annual Conference


Beyond Benchmarking: Financial and Operational Considerations as CHCs Approach Health Reform

2013 | PDF | Source: Rebecca Polan, Capital Link
As managers of Health Centers, we know our financial world is about to be turned upside down as our major revenue drivers in the fee-for-service model turn into our biggest drivers of costs. This session will talk through the major financial and operational trends that are emerging out of Health Reform, as well as strategies Health Centers in other states are using to prepare for the dramatic shift to global payments. We will discuss key financial and operational benchmarks that will continue to be important.
Presented at the 2013 MPCA Annual Conference


Supporting the Work of Health Centers Through New, Alternative Forms of Revenue

2013 | PDF | Source: John F. Frana, MBA, theFranaGroup
Have you ever thought about starting a foundation for your Health Center? Are you maximizing private philanthropy opportunities? What about starting a health and wellness program? Join us for a presentation and conversation focused on supporting the work of Health Centers through new, alternative forms of revenue.
Presented at the 2013 MPCA Annual Conference


Aligning Payment with Outcomes: Opportunities & Barriers for FQHCs

2013 | PDF | Source: Vernon K. Smith, PhD & Gaylee Morgan, MPP Health Management Associates
As major provisions of the ACA move toward implementation, policymakers increasingly are looking for ways to align payment methodologies with better outcomes and to incentivize value over volume. This session will provide an overview of recent developments in FQHC payment methodologies—both at the state Medicaid and individual health plan level—to achieve this alignment.
Presented at the 2013 MPCA Annual Conference



Additional Presentations

Employer Health Insurance Options Under Affordable Care Act

2012 | PDF | Source: Papazian Smalley & Harp
Presented at January 2013 Finance Officers Workshop


Affordable Care Act—Enrolling Newly Eligible Medicaid Patients

2012 | PDF | Source: Michigan Primary Care Association
Presented at January 2013 Finance Officers Workshop


Affordable Care Act—Implications for Medicaid Services

2012 | PDF | Source: Public Sector Consultants
Presented at January 2013 Finance Officers Workshop


Latest Developments from the State Medicaid Office

2012 | PDF | Source: Medical Services Administration
Presented at January 2013 Finance Officers Workshop


Preparing for Growth: Planning & Financing for Capital Expansion

2012 | PDF | Source: Capital Link
Provides a framework of the planning components necessary for successful Health Center expansion projects and discusses the best way to present project information to submit a winning proposal or loan application. The latest information on financing options, as well as some tools and tips for planning a capital campaign, are also included.
Presented at 2012 MPCA Annual Conference.


P
ay for Performance: Capturing Bonus Payments and Compensation Strategies to Incentivize Success

2012 | PDF | Source: InterCare Community Health Network
Maximizing revenue from patient services is critical to the mission of all Health Centers. This presentation explores one Michigan Health Center’s experiences, successes, and best practices in successfully capturing bonus/incentive revenue from Health Plans. It also details compensation planning for providers and other staff including base pay, bonuses, and incentives along with tips to successfully motivate behavior change using compensation strategy.
Presented at 2012 MPCA Annual Conference.


How to Stop Losing Money with Your Electronic Medical Record

2012 | Slidecast | Source: Mayo Foundation
Explains how to begin a process of solving data entry into the patient registry and improving a clinic’s productivity by using a free source of labor.
Presented at 2012 MPCA Annual Conference.

  

The Cost & Revenue of Seeing One More Patient
2012 | PDF | Source: Holton Healthcare Consulting, Inc.
Are you bumping heads with your Chief Medical Officer or Medical Director over productivity? Are you telling the Chief Financial Officer that it is quality that matters over productivity? Attend this workshop and see why you are both right. This session will demonstrate the cost benefit analysis of filling just one more patient appointment slot per provider without compromising quality and without additional burden to the health center of provider.
Presented at 2012 MPCA Annual Conference.


Turning the Lights on Michigan Medicaid Memorandum of Agreement

2012 | PDF | Source: Alcona Health Center, Health Delivery Inc., Thunder Bay Community Service
Covers why Michigan Health Centers have a Medicaid Memorandum of Agreement (MOA), how Michigan’s MOA was created, and which programs are covered and excluded.
Presented at 2012 MPCA Annual Conference.

 

Michigan Medicaid Reconciliation Report Preparation & Submission
2012 | PDF | Source: Michigan Department of Community Health
Presents new developments and an indepth review of the Michigan Medicaid reconciliation report preparation and submission.


Medicare Cost Report Training

2012 | PDF | Source: BKD
In order to remain financially viable, Health Centers must consistently capture available revenues from services provided to all patients, including Medicare beneficiaries. Understanding and completing the Medicare FQHC cost report timely and accurately is important to maintaining Medicare program revenues and cash flow.

 

Addressing Financing Issues in Providing Integrated Behavioral Health and Primary Care in Michigan
2012 | Slidecast | Source: SAMHSA-HRSA Center for Integrated Health Solutions
Webinar presented as part of 2012 MPCA webinar series supporting integrated care.


Optimizing the Billing Process: Expectations & Benchmarks

2012 | Slidecast | Source: Priority Management Group, Inc.
What does it cost you to get paid? What is your blended encounter rate? How many billing full time equivalents (FTEs) really work on your billing process and what should your total expense be as a percentage of payments? Are your days of accounts receivable (DAR) less than 50 days and if not, why not? This presentation explains how to go from good to great performance.


FQHC Intermediate Coding

2012 | Slidecast | Source: Priority Management Group, Inc.
This presentation is intended to answer Health Center documentation questions. Understanding what an auditor is looking for will enable the provider to finally have confidence in their E & M documentation and ICD Code selection. Providers and billers together learn why coding and documentation are important to the organization with real FQHC notes used in the discussion. After watching the presentation you will understand common Medicare denials resulting for improper coding and reimbursement restrictions due to errors in coding selection.


Complicated FQHC Encounters & How to Bill

2012 | Slidecast | Source: Priority Management Group, Inc.
FQHC billing is challenging with medical, behavioral, and dental programs coupled with cost based reimbursement and sliding fee scales. Add into the mix patient encounters, which are complicated, and staff members from clinicians to billing staff are often unsure the proper way to bill for these visits. In addition, if the encounter was billed, was it paid appropriately? Participants in this course learn the proper way to code and bill for encounters such as preventive and sick visits on the same date of service, modifier usage, Medicare and Medicaid rules for secondaries, what is included in the encounter rate, and what, if anything, can be billed separately.


Using Tools for Putting a Cost on Turnover

2012 | Slidecast | Source: Retention Institute
Discusses the Rethinking Retention Model, which was praised by Business Week as "fresh thinking for solving the turnover problem in any economy." Also discusses how to develop a retention infrastructure that aligns with sales, service, and other business priorities; how to place dollar costs on turnover across your organization to drive accountability; and how to develop reports that reinforce importance, reward achievement, and identify managers who need improvement.


Understanding and Implementing the FQHC Sliding Fee Scale

2012 | Slidecast | Source: Michigan Primary Care Association
Federally Qualified Health Centers (FQHCs) that receive HRSA funding or those that meet all the requirements of HRSA-funded Health Centers but do not receive funding (FQHC Look-Alikes) must provide access to services without regard for a person's ability to pay. During this webinar MPCA staff and an expert panel of three FQHC Chief Finance Officers provide information on HRSA/BPHC sliding fee scale policy and the practical implications of implementing a sliding fee on a day-to-day basis.
Webinar #2 of MPCA's 2012 governance webinar series.


Sorting Through Annual Wellness Visits, Preventive Services, and Initial Preventive Physical Examination

2012 | Slideshare | Source: Medical Management Systems of Michigan, Inc.
Provides the specific definitions and differences between these CPT/HCPCS codes; reviews the requirements and documentation of the Preventive Medicine Services; reviews what Medicare lists as the key elements of the AWV; and reviews the seven components of the Medicare Initial Preventive Physical Examination (IPPE).


Billing Medicaid for Nurses Visits in Health Centers

2012 | Slidecast | Source: Michigan Department of Community Health


MPCA Capital Development Technical Assistance Program & Kresge Assistance Project

2011 | PDF | Source: Michigan Primary Care Association
Discusses Health Centers' need for capital assistance in today's changing environment, and provides an overview of MPCA's Capital Development Technical Assistance Program and the Kresge Foundation's Assistance Project.
Presented at 2011 MPCA Annual Conference.


Health Center Risk Management

2011 | PDF | Source: Rehmann Healthcare Management Advisors
Touches on some of the risks that a Health Center faces today, which vary from the human factor of employees to the financial aspects of budgets and grant writing, to the clinical care in the delivery of services.
Presented at 2011 MPCA Annual Conference.

 

Health Center Coding & Billing: Part 1

2011 | Slidecast | Source: Priority Management Group, Inc.
Provides an overview of E & M coding, a unique Health Center-specific reimbursement discussion, and revenue opportunities.


Health Center Coding & Billing Part 2

2011 | Slidecast | Source: Priority Management Group, Inc.
Offers in-depth understanding of the coding algorithms, 95 vs. 97 guidelines, documentation requirements, modifier usage, and medical necessity.


Health Center Coding & Billing: Part 3

2011 | Slidecast | Source: Priority Management Group, Inc.
Offers in-depth understanding of the coding algorithms, 95 vs. 97 guidelines, documentation requirements, modifier usage, and medical necessity.


Health Care Reform—What is Happening in Medicaid and Medicare and What Are the Connecting Points and Opportunities?

2011 | PDF | Source: Michigan Primary Care Association
Provides an update on major national reform efforts surrounding Medicaid and Medicare, as well as state efforts to reform their Medicaid programs. The focus is on potential points of connection and opportunities for Health Centers in the areas of innovative service model design, payment models, and patient engagement.
Presented at the 2011 MPCA Annual Conference

 

Health Center Financial Performance Indicators
2011 | PDF | Source: Michigan Primary Care Association
Reviews the different Health Center financial indicators available, including how they are calculated and how they are interpreted.
Presented at 2011 MPCA Annual Conference.


Federal Audit Requirements & Fraud Protection

2009 | Slidecast | Source: Plante & Moran
Provides an overview of changes to the single audit requirements and the impact of the American Recovery and Reinvestment Act (ARRA). Also discusses new auditing standards and accounting pronouncements, and provides guidance on how to protect against fraud and other internal control related matters.
Presented at 2009 MPCA Annual Conference

 

Overhauling Health Center Operations: Project RevUp 101
2009 | PDF | Source: Michigan Primary Care Association
Overview of program for redesigning Health Center operations.
Presented at 2009 MPCA Annual Conference

Resource Documents

Sliding Fee Schedule Board Document

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

 

MI Health Link Contact List for Provider Contracts
2015 | PDF | Source: Michigan Department of Community Health

 

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

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

 

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


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.

 

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


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.

 

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 Community Health
Vaccines for Children (VFC) program Q&A including information on vaccine administration fees.

 

Medicare Learning Network
2015 | 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.


Medicare for Michigan & Indiana Providers

2015 | Website | Source: WPS Health Insurance

 

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. 

 

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

Additional Resource Documents

Grants Management Tutorial

Website | Source: Health Resources & Services Administration
Assists Health Centers in successfully administering and fiscally managing federal grant dollars.


Medicare Claims Processing Manual: Rural Health Clinics/Federally Qualified Health Centers

2010 | PDF | Source: Centers for Medicare & Medicaid Services
Chapter 9, which covers Rural health Clinics and Federally Qualified Health Centers. Explains the differences between the two, the method of Medicare payment for each, payment reconciliation, allowable costs, and much more.

 

Medicare Electronic Prescribing (eRx) 
2011 | Website | Source: National Association of Community Health Centers
Information on FQHCs and the Medicare eprescribing payment adjustments and incentives.

  

School-Based Health Center Program Billing Resources
Wiki | Source: Alliance Practice and Data Management 
Primarily focused on school-based billing, coding and practice management.


ICD-10 "PlayBook"

Website | Source: HIMSS
Online toolkit of planning, assessment and implementation resources for ICD-10.


ICD-10 Watch

Website | Source: HealthcareIT News & Healthcare Finance News
Website and eNewsletter with the latest ICD-10 news, updates and resource links.


ICD-10 Training for Offices/Clinics

Website | Source: AAPC
Training and resources to help prepare your organization for the ICD-10 transition.

 

Medicare


FQHC Webpage

Website | Source: Centers for Medicare & Medicaid Services
Includes links to specific claims processing, benefit eligibility, and reimbursement manuals for Medicare.


CMS' Medicare Website

Website | Source: Centers for Medicare & Medicaid Services
Provides general information, billing, Medicare fee-for-service payment, links to CMS forms, coding, compliance and audits, and much more.

 

Medicare Benefit Policy Manual: Rural health Clinic and Federally Qualified Health Center Services
2009 | PDF | Source: Centers for Medicare & Medicaid Services
Chapter 13, which covers services provided by Rural Health Clinics and Federally Qualified Health Centers.


Medicare UB-04 Revenue Codes

2010 | PDF | Centers for Medicare & Medicaid Services


Michigan Medicaid

Website | Source: Michigan Department of Community Health
Supplies coverage, billing, and reimbursement policies and other important information for enrolled providers. Much of the information provided also applies to other health care programs administered by MDCH (e.g., Adult Benefits Waiver, MOMS, Plan First!, Children's Special Health Care Services, etc.).

 

Medicare Enrollment Guidance
PDF | Source: Centers for Medicare & Medicaid Services
For physicians that infrequently receive reimbursement from the Medicare program, including those employed at FQHCs. This type of enrollment is for the purpose of certifying or ordering services for Medicare beneficiaries using an abbreviated CMS 855I form.

 

Medicare Revalidation
Website | Source: Centers for Medicare & Medicaid Services
Section 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers and suppliers to revalidate their enrollment information.

 

Medicaid

 

Medicaid: A Primer
2010 | PDF | Source: Kaiser Family Foundation
Provides an overview of the basic components of Medicaid, the nation's largest health coverage program for low-income individuals, including children and families, people with disabilities and seniors who are also covered by Medicare. Medicaid also is the dominant source of the country’s long-term care financing. The primer examines how the program is structured, who it covers, what services it provides, and how much it costs. It also provides an overview of how Medicaid will change and significantly expand as it plays a key role in the new health reform law, serving as the mechanism to provide coverage to millions of previously uninsured low-income adults and children.

 

Michigan Medicaid Health Plans
Website | Source: Michigan Department of Community Health
Includes a list of Medicaid health plans operating in Michigan and their contact and service listing.

 

Medicaid Enrollment of Nurse Practitioners and Physicians Assistants
2012 | PDF | Source: Michigan Department of Community Health, Medical Services Administration
Provides information on enrolling and billing for nurse practitioners and physician assistants in CHAMPS.

 

MDCH ICD-10 Webpage
Website | Source: Michigan Department of Community Health
Michigan's ICD-10 implementation page including documents, web-based training and code equivalence mappings.


CMS ICD-10 Webpage

Website | Source: Centers for Medicare & Medicaid Services
National implementation webpage including provider resources, timelines and updates.

 

Tools & Templates

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

 

Discounted Fee Schedule

2015 | Website | Source: National Health Service Corps  


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

2011 | 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)

2011 | 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 either this Internet-based Provider Enrollment, Chain and Ownership System (PECOS) or the PDF CMS 8551 form.


CHAMPS: Michigan Medicaid Processing System

Website | Source: Michigan Department of Community Health
Michigan Health Centers must enroll using CHAMPS to receive reimbursement from Medicaid.



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