RHC Medicare Billing Resources

Healthcare Business Specialists, LLC is pleased to provide you with these billing resources to help your rural health clinic bill Medicare for your services. Billing RHC services requires the ability to create a UB-04 in an electronic format (837I). Many clinics that are new to RHC billing rely on outside help to bill for services. We have worked with AMS Software out of Raleigh, North Carolina who has been working with RHCs on billing since 1989.  Many RHCs need access to Direct Data Entry (DDE) to verify coverage or adjust claims. Many of our clients use  Ability to connect to Direct Data Entry.

RHC Beginning Billing Series in December, 2018. Three Sessions were recorded in December. We will have one more in January, 2019. Here are the links to the recordings of the webinars.

Here are the PDFs we used at each of the webinars if you want to follow along on payer or take notes.

Tenncare Billing Resources

Tenncare was granted a moratorium for paying RHCs the enhanced RHC reimbursement rate effective October 25, 2017. We have included links to many of the documents regarding the moratorium. Please click the link below:

If you are a new RHC, you can now submit your quarterly Tenncare Wrap reports and recieve interim reimbursement at the average rates established by Tenncare for each of the Grand Divisions of Tennessee. The rates are as follows:

The interim rates are:

West     $141.49

Middle  $131.35

East        $137.99

Healthcare Business Specialists Beginning Billing for Independent Rural Health Clinics Webinar Series in February, 2018

In February, 2018,  Healthcare Business Specialists, LLC conducted a series of webinars on RHC billing for Independent RHCs. We have provided the information from the webinars including PDFs of the slides and links to the recording of the presentations on Youtube:

The Youtube Recording of the sessions are below:

Medicare Online Manuals with RHC Billing Guidance:

Healthcare Business Specialists RHC Billing Policies

RHC Billing Guides and Tables from Medicare Administrative Contractors:

Chronic Care Management Information:  Below are links to information presented August 1st, 2017 on the new CCM guidelines for RHCs effective January 1, 2018 by CMS: