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  • 215 S Wadsworth Blvd Unit 400 #732
  • 732-366-3644
  • info@eastbilling.com
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FQHC Billing Services That Eliminate Compliance Risks

Federally Qualified Health Centers face billing challenges far beyond standard practices — PPS reimbursements, wraparound claims, Medicaid managed care plans, and complex UDS reporting. Many billing vendors treat FQHCs like any other clinic, leaving millions unrecovered or exposing centers to audit risk.

East Medical Billing is different. We design billing workflows specifically for FQHCs, ensuring encounter-based claims are coded, submitted, and reconciled accurately the first time.

  • PPS and wraparound claims processed without delay
  • UDS reporting simplified and audit-ready
  • Medicaid and managed care claims scrubbed for compliance
  • Book a free audit and see how much revenue your health center may be leaving behind.
Request Free Audit

Eliminate Hidden Gaps in FQHC Billing

The National Association of Community Health Centers reports that FQHCs lose 10–15% of annual reimbursements due to billing errors and missed processes. These losses aren’t one-off mistakes — they happen every day when PPS encounters are miscoded, wraparound claims are skipped, or UDS data isn’t captured completely.
Every gap reduces funding and raises compliance risk. Missed encounters mean underpaid PPS claims. Unfiled wraparound claims cut off supplemental revenue. Medicaid managed care rules vary by state, causing repeated denials. UDS reporting gaps threaten HRSA compliance and grant eligibility.
  • PPS encounters billed incorrectly → underpayments
  • Wraparound claims never filed → lost supplemental dollars
  • Managed care Medicaid rules missed → denials and delays
  • UDS reporting incomplete → compliance and audit exposure
East Medical Billing prevents these issues with FQHC-specific billing workflows. We build processes around PPS rules, track every wraparound claim through payment, and ensure Medicaid requirements and UDS reporting are met without error.

Our FQHC Billing Process That Secures PPS and Wraparound Payments

Every step is designed to prevent leakage, expedite reimbursement, and maintain your practice’s financial strength with accountable billing workflows.

1

Capture every encounter accurately

Each patient visit logged with complete details. PPS encounters coded and linked correctly. No visits lost or underpaid.

2

Submit wraparound claims without delay

Supplemental claims filed promptly. State and federal rules applied. Centers receive the full revenue owed.

3

Apply state-specific Medicaid edits

Managed care requirements checked before release. Eligibility confirmed. Claims match payer rules by state.

4

Reconcile payments daily

Every ERA and EOB posted within 24 hours. Underpayments flagged immediately. Variances tracked and escalated.

5

Correct denials within 48 hours

Errors categorized. Appeals written to payer policy. Resubmissions stay inside filing limits. Revenue recovered instead of written off.

6

Maintain UDS compliance

Data captured and structured for HRSA reporting. Metrics reconciled with claims. Compliance supported at every step.

7

Provide transparent audit trails

Every encounter traceable. Coding, edits, and payer checks logged centrally. Reports are audit-ready at all times.

8

Support providers with denial insights

Denial patterns tracked by payer and reason. Training and feedback loops close gaps. Future claims avoid repeat mistakes.

Compliance-Driven FQHC Billing for Sustainable Funding

FQHC billing is compliance, payer policy, and timing. We apply PPS and wraparound rules early, reconcile payments daily, and keep UDS reporting complete so funding is never at risk.
  • Dedicated FQHC billing specialists on every account
  • PPS and wraparound automation to capture supplemental revenue
  • State-specific Medicaid edits built into submission workflows
  • Real-time eligibility verification before every encounter
  • Denial resolution tracked with 48-hour turnaround
  • UDS reporting support integrated into billing cycle
  • Weekly variance and underpayment reviews
  • HIPAA-compliant audit-ready workflows
  • Cloud dashboards that track AR days and denial trends
  • Scalable support for single-site and multi-site FQHCs
With structured FQHC billing operations, health centers protect revenue, shorten AR cycles, and stay compliant without straining staff capacity.

Recover missed wraparound claims

Request PPS & Wraparound Audit

Simplify UDS reporting and compliance

Book Free FQHC Billing Consultation

FQHC Medical Billing Services That Secure Compliance

Encounter-based billing. PPS and wraparound claims were submitted correctly. Medicaid rules applied. UDS reporting is structured. Compliance protected every step.
Request Free Audit
WHY CHOOSE US

How East Medical Billing Delivers Transparency and Control

East Medical Billing uses FQHC-focused technology to track PPS encounters, file wraparound claims, and reconcile Medicaid requirements with complete accuracy daily.
  • Automated wraparound claim workflows we manage
  • Medicaid edits applied through our systems
  • Eligibility verified before claims leave our queue
  • Payments posted within 24 hours by us
  • UDS data captured inside our reporting cycle
  • HIPAA-secure cloud dashboards we provide clients

Automation Customized For Your FQHC

We configure billing automation to your state and payer requirements so PPS and wraparound claims flow without manual delays or errors.

Daily Transparency Through Our Dashboards

Our cloud dashboards show payment posting, denials, and AR cycles so leadership tracks revenue health in real time every day.

Compliance Integrated In Our Processes

We capture UDS reporting data inside our billing cycle and apply HRSA standards so your center remains audit-ready at all times.

Why Choose East Medical Billing

We specialize exclusively in FQHC billing, combining compliance-focused workflows with daily reconciliation and transparent reporting that protect reimbursements and federal funding.

FQHC-Only Billing Expertise

Our team understands PPS rules, wraparound claims, Medicaid requirements, and UDS reporting ensuring accuracy where general billing companies consistently fail.

Compliance at Every Step

We embed HRSA standards and state-specific Medicaid edits into each workflow protecting centers from denials, underpayments, and costly compliance exposures.

Transparent Revenue Oversight

We provide real-time dashboards, weekly reviews, and audit-ready reports so leadership has complete visibility into financial performance and reimbursement outcomes.

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Testimonials

What Providers Say About Us

Real results from practices that partnered with East Medical Billing.

We struggled with denials on complex cardiology procedures. Within 90 days, EMB reduced our denial rate by 45% and improved collections significantly. Now we can focus fully on patient care.

Cardiology Practice New York

Our FQHC billing was a nightmare with PPS and wraparound claims. East Medical Billing fixed our encounter billing workflows and kept us compliant with UDS reporting. We are finally audit-ready.

Dr. A. Singh, Cardiologist FQHC, Texas

With high patient volumes, claims piled up fast. EMB’s real-time eligibility and aggressive AR follow-up turned our 90-day aging AR into collected revenue.

Operations Director, Community Health Center Urgent Care, Florida