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FQHCs Need Eligibility at Their Fingertips

Sep 16, 2020 9:47:17 AM

Federally Qualified Health Centers currently serve about one-twelfth of the U.S. population, delivering healthcare to our most disadvantaged communities. 

The spread of COVID-19 strained many of our nation’s FQHCs, which were already critical to the response for at-risk neighborhoods. Looking forward, we anticipate an increase in patients seen at FQHCs as unemployment causes uninsured, low-income and Medicaid recipient numbers to continue to rise.

Precise eligibility verification isn’t just a nice-to-have; in this critical capacity environment and with insurance benefits changing for many, it’s crucial for FQHCs who have limited budgets. It means less stress for front desk staff, faster reimbursement and a quicker bottom-line recovery from the under-resourced 2020 public health crisis.

Supporting FQHCs in terms of eligibility covers several areas, including solutions for:

  • Accurate data collection and data cleansing 
  • Robust data collection for compliance and reporting needs
  • Flagging managed care coordinators before treatment
  • Walk-in patient data collection
  • Ease-of-use for a diverse and multi-lingual population
  • Simple new staff training that doesn’t require mastery of the intricacies of a governmentally funded program
  • Mapping of complex payer services

Thorough Verification and Data

Clearwave’s Eligibility-as-a-Service engine provides the most rigorous insurance verification on the market, run up to seven times to ensure coverage before service. Comprehensive verification means drastically lowered insurance claims denials and quicker reimbursement – a must for FQHC administrators.

For displaced or migrant patients, it’s vital to ensure that information changes are flagged to avoid duplicate or outdated accounts. Clearwave identifies duplicate entries and provides clean data before billing. Clearwave also collects robust data that gives FQHCs the ability to report their work in detail - facilitating continued funding.

Accuracy

Spotting a managed care coordinator prior to treatment is straightforward with Clearwave’s eligibility engine. This alerts staff to ensure the FQHC is listed as the managed care coordinator to be able to receive payment, providing the information right at their fingertips. 

Clearwave also makes it easy to receive walk-in patients, collecting data as they come in the door. And with patient registration offered in multiple languages, FQHCs can serve diverse communities in their language of choice without skipped questions or miscommunication.

Simplicity

The environment of FQHCs is challenging at times and can result in disruptive, high staff turnover. Having an uncomplicated platform for scheduling, check-in and registration makes it easy to train and manage new hires. It also doesn’t require them to understand the complexities of FQHCs while welcoming patients, which can relieve the pressure on management.

We are also adept at navigating complex payer systems, such as Medi-Cal, for California-based FQHCs.

Equipping our FQHC partners with easy access to robust, clear, eligibility data is the best way we know to support their good work. Schedule a demo for your FQHC here and let us show you the opportunities.

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