Updates from your ACE team

Expand your practice to achieve financial independence

With only two months left in 2019, this is the perfect time to ensure you have the right building blocks in place to deliver maximum revenue for the remainder of the year, and set up for strong growth in the new year. Let's look at an easy win first. If you haven't already, don't forget to review your self-pay balance for retroactive reimbursement opportunities - this can generate additional revenue in a short period of time with no disruption to operations. Don't have a spare resource to dedicate? We can help! See below for details. Next, let's look at credentialing. This is one of the top claim denial reasons we see, which unfortunately results in write offs that could be avoidable. Accurate (and fast) credentialing is critical to revenue generation, but can be resource intensive to manage in-house. Below we provide some tips and a handy fact sheet. For longer term growth, we've seen a lot of focus lately on mental and behavioral health - some of the statistics are staggering. Integrated behavioral health provides a significant expansion opportunity, and is an area that many FQHCs haven't fully explored. In the media, we've seen HHS announce proposed changes to modernize the Stark Law and Anti-Kickback Statute and award $319 million to support health providers caring for the underserved through the National Health Service Corps (NHSC). CMS recently celebrated its two-year anniversary of the "Patients Over Paperwork" initiative, plus outlined its vision for delivering value-based vs. encounter-based care and the future of Medicare and Medicaid. And NACHC launches its new Unity for Community Health Day. Keep reading for more details.

ACE team out and about

Thanks for visiting us!! Earlier this month we exhibited at the GPCA annual conference. It was great to catch up with old friends, make new ones, and hear about the challenges you're facing. Supporting community We take every opportunity to support our clients' communities, and recently had the privilege to attend MCR Health's annual fund-raising event. Our team enjoyed great food for a great cause!

Maximize your billing revenue

Are you writing off self-pay too soon? In many cases, Medicaid coverage can be applied retroactively, providing an opportunity to recoup revenue that would otherwise be written off.   This can generate additional revenue quickly! (Click on image to expand)   Read our flyer and contact us to find out how this could improve your bottom line.

Are your providers correctly credentialed? Accurate and up to date provider credentialing confirms that your providers are qualified and capable of delivering safe and reliable care for your patients. It's also a critical enabler of revenue generation, since reimbursement from Medicare, Medicaid, and commercial payers represents a significant source of income for FQHCs. It can make the difference between getting paid and not!  We emphasize the importance of credentialing as it is the one factor that can result in denials, regardless of how streamlined the RCM process is . If providers are not correctly credentialed, they cannot be enrolled with payers. This means that claims may be denied - which equates to lost revenue. Read our Credentialing Fact Sheet for more info. When was the last time you reviewed all of your provider credentials and contracts? Do you have a dedicated resource managing the process?

A credentialing audit can help you identify gaps and revenue opportunities - click here to find out how.

Mental health is important at all ages! This month, we've seen some scary sta tistics about mental health, both in adults and children. The Kaiser Family Foundation published new reports showing that nearly 17 million adults (ages 18 and up) and 3 million adolescents (ages 12-17) reported having a major depressive disorder in the past year. And just last week, new HRSA data emphasized the importance of behavioral health services as part of pediatric care. According to th e 2018 National Survey of Children’s Health (NSCH), one in three children under the age of 18 have experienced stressful traumatic events that are strongly related to a wide range of health problems throughout a person’s lifetime. Many of those affected rely on community health centers. Are you equipped to care for these patients through their highest highs and lowest lows?

Let’s talk about how we can assist you can expand your practice to encompass behavioral health and change lives together.

Media watch and other useful info

NACHC UPDATES Unity for Community Health Day - November 12 NACHC is urging everyone involved in community health center operations to take a pledge and commit to scheduling time to meet your local congressional office for the first annual Unity for Community Health Day. The website provides an outline of what to do, how to do it, and when. Another short-term funding extension likely through early 2020 The deadline for passing proposed annual spending bills is November 21, however it's looking unlikely that the bills will be passed before that date. Negotiations are ongoing, but leaders are already discussing another short-term funding extension - at this stage, it's unclear what the impact will be on Community Health Center funding. Read this article for the latest.

HHS UPDATES Proposed changes to Stark Law and Anti-Kickback Statute HHS has p roposed changes to modernize and clarify the regulations that interpret the Physician Self-Referral Law (the "Stark Law") and the Federal Anti-Kickback Statute. These proposed rules aim to better support value-based and coordinated care , and if finalized, address the longstanding concern that these laws unnecessarily limit the ways in which healthcare providers can coordinate care for patients.  Funding awarded to support health providers caring for the underserved HHS announced $319 million in scholarship and loan repayment awards for clinicians and students through the National Health Service Corps (NHSC). Medical and dental students in their final year of school may receive awards of up to $120,000 in exchange for a three-year commitment to provide primary care services in high-need areas. Read the press release for more details. 340B Drug Pricing Program The October OPA Program Update is now available, focusing on 340B ceiling price reporting. CMS UPDATES Patients Over Paperwork anniversary CMS Administrator Seema Verma spoke at the initiative's two-year anniversary event, discussing successes so far and the work still required. Read the full remarks on the website. Vision for the future Administrator Verma also presented the role of government in healthcare, and CMS' vision recently. The vision includes three key elements: p roviding a safety net for the most vulnerable, ensuring the sustainability of government programs, and setting fair ground rules for a competitive healthcare market. RFIs: Medicare Program Integrity CMS is focusing on ways to combat waste, fraud, and abuse in the Medicare program and i s developing a five-pillar program integrity strategy. It is seeking input from the healthcare community on the program integrity challenges involved in the transition from a fee-for-service system to value-based care, as well as on new techniques & approaches involving advanced data analytics and artificial intelligence.  More detail on the website . Reference Stay up to date with the latest Medicare and Medicaid updates for FQHCs.

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