Measuring FQHC Performance in Billing and Collection Services

This white paper discusses the performance measurement of billing and collection services within Federally Qualified Health Centers (FQHCs). It outlines the critical role these services play in the financial health of FQHCs, particularly in the context of rising costs and declining reimbursements. The paper emphasizes the importance of establishing a comprehensive system for measuring performance through key performance indicators (KPIs) and benchmarks. It details various KPIs, such as Days in Accounts Receivable, Collection Rate, and Denial Percentage Rate, which are essential for assessing the effectiveness of billing processes. The document also addresses the challenges faced by FQHCs in managing in-house revenue cycle management (RCM), including personnel challenges and operational disruptions. Furthermore, it presents the potential benefits of outsourcing RCM, such as cost savings and improved focus on patient care. The paper concludes with a case study illustrating the successful outsourcing of billing services at North Shore Community Health Center, which resulted in significant revenue growth.