There are many reasons for FQHCs to focus on Medicare today. Nationwide, health centers’ Medicare population is growing. Each year, the Medicare program grows in scope and complexity, embracing new preventive and technology-based care and offering a range of new services, such as care coordination, that help patients maintain wellness and manage chronic conditions. By improving their Medicare expertise, health center leadership and operational teams can advance patients’ health outcomes, take best advantage of new revenue opportunities, and avoid Medicare compliance pitfalls. And in a time of budgetary uncertainty, focusing on billing compliance and revenue maximization is good business practice.

This two-day intensive training, led by attorney Kathy Ghiladi and Rebekah Wallace Pardeck of Achieve Revenue Management, will help health center personnel address challenges and identify opportunities in serving Medicare patients. Topics addressed include the following:

• Covered services within the Medicare FQHC benefit 
• Payment under the FQHC prospective payment system (PPS) 
• Advanced billing guidance (e.g., establishing G code charges; billing for telehealth and care management services) 
• Enrolling and staying enrolled in Medicare as an FQHC 
• Medicare-Medicaid dual eligible beneficiaries 
• Obtaining supplemental (“wrap”) payments for services rendered to Medicare Advantage enrollees 
• Medicare coinsurance considerations 
• Care management services and remote monitoring services
• Recent changes in Medicare coverage and payment for telehealth and virtual services. 

Participants can expect to leave the training with a greater understanding of how to structure health center provider enrollment policies, billing and coding practices, fee schedules, and service offerings in order to provide effective care for Medicare patients.