Please Note: This training is limited to community health centers and look-alikes. If you are not affiliated with a health center and would like to attend, please contact us.

As the Medicare population continues to grow and the complexity of the program increases, health center leadership and operational teams need to improve their Medicare expertise in order to optimize care for Medicare patients, maximize Medicare payment, and avoid Medicare compliance pitfalls. Medicare has played a key role in health centers’ operational stability during the COVID-19 pandemic, providing for payment for COVID-19 vaccinations and treatments and leading the way for other payors on telehealth coverage and payment for FQHCs.

In this three-day intensive training, Susannah Vance Gopalan will team up with Rebekah Wallace Pardeck of Achieve Revenue Management.

Day 1, Medicare FQHC Program Fundamentals, will cover basics of Medicare for FQHCs, such as covered services within the Medicare FQHC benefit, Medicare conditions for coverage, and the structure of the prospective payment system (PPS). 

Day 2, Additional FQHC Payment Considerations, will focus on payment issues such as establishing “G code” charges for FQHC visits, billing the Medicare program for services that fall outside the FQHC benefit, and obtaining payment for services to dual eligible (Medicare-Medicaid) beneficiaries. 

Day 3, Advancing Medicare in the FQHC, will consider strategic decisions health center leaders can make to optimize care for Medicare patients in health centers. Among other topics, we will address telehealth and virtual communication services and obtaining supplemental (“wraparound”) payments from Medicare for services provided to Medicare Advantage enrollees.