5 Star Billing Services delivers specialized FQHC medical billing solutions designed to meet the complex demands of PPS, Medicaid, and Medicare reimbursement models. By combining deep FQHC regulatory expertise with AI-driven automation, we ensure cleaner claims, faster reimbursements, and reduced denials while maintaining full compliance. Our solution-driven approach streamlines workflows, improves financial visibility, and empowers Federally Qualified Health Centers to focus on patient care with confidence and financial stability.
FQHC billing operates under Medicare PPS, Medicaid-specific rules, and HRSA oversight—demanding precision, experience, and compliance-driven workflows.
FQHCs are paid per qualified encounter rather than per individual service, making correct encounter identification critical to reimbursement.
FQHCs bill under Medicare PPS and state-specific Medicaid methodologies, requiring precise rate application and reporting.
Billing rules for same-day medical, behavioral health, and preventive visits are highly specific and differ from traditional practices.
FQHC billing requires specialized use of HCPCS codes, modifiers, and revenue codes unique to FQHC claim submission.
Patient discounts must be applied according to HRSA guidelines without altering billable encounter values.
Accurate billing directly impacts annual cost reports and HRSA audits, making documentation and data integrity essential.
Given this complexity, many FQHC turn to billing specialists to protect their revenue and reduce administrative burden.
We manage complex FQHC billing rules so your encounters are billed correctly the first time.
We accurately bill qualified medical encounters under Medicare and Medicaid PPS, ensuring each encounter meets FQHC billing criteria.
Our AI-powered checks validate CPT, HCPCS, and modifier usage to reduce coding errors before claims are submitted.
We submit claims in the correct FQHC-required formats, reducing rejections related to payer-specific billing rules.
We apply correct billing rules for same-day medical encounters to ensure compliant and payable claim submission.
Denied or unpaid claims are analyzed, corrected, and resubmitted based on payer-specific FQHC billing guidelines.
We post payments and adjustments correctly against billed encounters to maintain accurate medical billing records.
Holmes Chiropractic
FQHC billing is encounter-based and reimbursed under Medicare PPS and state-specific Medicaid methodologies, requiring specialized coding, claim formatting, and payer rule alignment that differs from fee-for-service billing.
Yes. Our FQHC services focus strictly on medical billing functions, including encounter billing, claim submission, denial resolution, and payment posting—without non-billing operational services.
We use AI-driven validation to identify coding, modifier, and claim-formatting errors before submission, helping reduce rejections and improve first-pass claim acceptance.
Yes. We submit and manage claims in compliance with Medicare PPS requirements and Medicaid FQHC billing rules, including state-specific payer guidelines.
Outsourcing reduces internal billing workload, improves encounter accuracy, minimizes denials, and supports faster reimbursements through specialized FQHC billing expertise.
Specialized billing processes that reduce errors and payment delays.
Specialized FQHC billing expertise ensures every qualified medical encounter is billed correctly under PPS guidelines.
Pre-submission validation and payer-specific billing rules minimize avoidable errors that lead to rejections.
Clean claim submission and proactive follow-up help reduce payment delays from Medicare and Medicaid.
Outsourcing eliminates the need to manage in-house billing staff while maintaining consistent billing performance.
Dedicated billing specialists stay aligned with Medicare and Medicaid FQHC requirements to avoid costly mistakes.
Accurate payment posting and reconciliation provide clear visibility into billed encounters and received payments.
Join hundreds of healthcare providers who trust us to handle their medical billing with precision and care.
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+1-480-999-0180
info@drbillingservice.com
2150 W Cheyenne Dr, Chandler, AZ 85224, United States
Open 24 hours