Rural Health Billing Strategy Advisory

💲 Price: $3,250 (One-time)
Add-on: RHC Modifier and Claim Review +$500

Overview

Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) face unique billing and compliance challenges—from consolidated billing rules and cost-based reimbursement to special modifiers and provider qualifications.

Thrive’s Rural Health Billing Strategy Advisory delivers tailored support to help your organization navigate rural billing complexities, ensure proper revenue recognition, and optimize your operational workflows.

Ideal for:

• Independent and provider-based RHCs
• Small hospitals and FQHCs
• Practices transitioning to or managing RHC designation

What’s Included

• One-on-one consultation with a senior rural billing expert (2 sessions)
• Strategic assessment of:
  • RHC-specific billing requirements
  • UB-04 vs. CMS-1500 workflows
  • Incident-to billing and provider scope
  • G codes, modifier usage (e.g., CG), and carve-outs
  • Cost report implications and charge strategy
• Review of payer mix and managed care contract impact
• Recommendations to reduce compliance risk and revenue leakage
• Optional: Sample UB-04 review + modifier audit (add-on)

Deliverables

• Final Rural Billing Strategy Brief (PDF)
• Coding/charge documentation recommendations
• Suggested SOP outlines or workflow tweaks
• Optional UB-04 review summary (if add-on selected)

How It Works

1. After purchase, you complete a brief RHC profile intake form.
2. Thrive reviews key documents (payer list, charge sheets, denial samples).
3. Two Zoom strategy sessions are scheduled over 10 days.
4. You receive a custom advisory brief and follow-up resources.

ROI & Benefits

• Clarify appropriate billing models and scope-of-practice billing
• Reduce denials tied to incorrect modifiers or visit bundling
• Protect reimbursement through strategic RHC compliance
• Improve audit readiness and cost report alignment
• Better understand and negotiate managed care agreements

Timeline & Delivery

• Advisory sessions completed within 10–14 business days
• Brief delivered within 5 days post-session
• Add-on audit summary: +3 business days

Compliance Note

All strategies are aligned with CMS, MAC, and OIG guidance for rural health providers. Thrive signs a Business Associate Agreement (BAA) with all clients and ensures HIPAA-compliant workflows.