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Wiki FHC question re: Step Outside Your Coding Bubble Into FQHC Services

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JulieCzyzewski

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I have a question regarding billing new versus established patients in an FQHC. Does how the insurance company has your providers credentialed matter? For instance, I have some insurances that credential one specialty as a group and another as individual providers but in neither circumstance does the insurance company recognize us as an FQHC. They see us as a group. And, for the insurances that credential our providers as individuals and not a group does that effect anything? Or, does none of this matter and if the provider works for an FQHC regardless of how they are credentialed I should only bill the first encounter as a new patient and all others as established?

I appreciate any insight on this. Thank you.
 
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