Revenue Cycle Management for FQHCs

Revenue Cycle Consulting for Community Health Centers

Insurance Contract Review & Payer Optimization

Our proactive approach to regular insurance contract reviews supports appropriate compensation for services, identifies underpayments and reduces denial risk, and renegotiate contracts that no longer reflect operational costs or current service offerings—strengthening payer relationships and financial sustainability. 

Cost-Based Fee Schedule Development

We develop and update fee schedules that reflect current market rates, payer reimbursement levels, and operational costs, reducing underbilling, denial risk, and audit exposure.

Denial Management & Claims Resolution

We identify the root causes of claim denials, implement process improvements to prevent them, and resolve outstanding denied claims systematically—often resulting insignificant denial-rate reductions within the first year.

Interim Revenue Cycle Management

During leadership transitions, staff vacancies, or periods of operational change, our interim RCM leaders provide expert oversight of the full revenue cycle, ensuring billing accuracy, timely reimbursement, and compliance continuity while permanent capacity is restored. 

KPI Reporting & Data Analytics

We implement comprehensive KPI dashboards tracking days in accounts receivable, denial rates, clean claim rates, collection percentages, and payer mix performance. Leadership can regularly use these indicators to identify trends, address issues early, and make informed decisions about resource allocation and process improvement.

Staff Training & Development

We provide training and mentorship for front-end and back-end revenue cycle functions, building the internal competency needed to maintain improvements and adapt to evolving payer requirements over time.