Optum PM and Physician EMR for Federal Qualified Health Centers (FQHC)
When medical practices see an increased number of uninsured or underinsured patients, maintaining physician compensation amidst declining reimbursements is a top concern, particularly for Federally Qualified Health Centers (FQHC) that are funded by limited federal resources. Optum PM and Physician EMR recognizes the specific FQHC billing and reporting requirements that must be met in order to submit claims and receive reimbursements from all sources.
Optum PM and Physician EMR FQHC functionality was designed exclusively for non-profit Community Health Centers and is fully integrated with the Optum PM and Physician EMR practice management. This FQHC functionality is now included within Optum PM and Physician EMR at no additional cost to users. Because FQHCs serve underserved populations, they must be able to provide a sliding fee scale as well as comprehensive services. This makes reimbursement issues even more complex. Optum PM and Physician EMR Electronic Household Assessment helps FQHCs front office staff:
- Improve efficiency and remove manual errors by automatically determining your patient’s sliding fee scale eligibility
- View a patient’s sliding fee eligibility, determine their co-pay, and inform the patient of their financial responsibilities on arrival
- Serve your practice’s diverse patient population with the ability to print assessment in multiple languages
Administrative benefits
Optum PM and Physician EMR for FQHC allows your practice to capture and store special population data and helps FQHCs to maximize revenue from all possible sources.
- All eligibility and insurance information is always visible on your dashboard so your front office staff does not need to calculate adjustments or track co-pays
- The system tracks when a patient needs to renew their Household Assessment and automatically notifies the front office staff of status
- Automatic notifications help your practice to maintain current information and eligibility and compliance deadlines
Flexible configuration
With Optum PM and Physician EMR FQHC flexible Sliding Fee Scale configuration, your practice has the tools to:
- Manage poverty guidelines, slide type income thresholds, and discounts that meet your region’s needs
- Set assessment renewal dates that trigger notifications in the system as well as maximum balance limits and adjustment codes per slide
- Choose between a purely discount-based slide fee scale, a service co-pay-based fee scale, or a combination of the two
Automated rate adjustments
With Optum PM and Physician EMR, charge entry is easy; all sliding fee adjustments are computed automatically based on your patient’s sliding fee eligibility. Even if the patient has a primary insurance carrier, sliding fee adjustments will be transferred automatically upon payment.
Uniform Data System (UDS) FQHC Reporting
Federal funding is a critical component that enables your FQHC to operate successfully. Optum PM and Physician EMR FQHC reports are targeted at the UDS reporting standards to ensure your practice meets federal guidelines.
For more information, download the product sheet.
