Rural Health Clinics

Rural Health Clinics (RHCs) are clinics that are located in areas designated by the Bureau of the Census as rural and by the Secretary of Department of Health and Human Services (DHHS) or the State as medically underserved. RHCs have been eligible for participation in the Medicare program since March 1, 1978. Services rendered by approved RHCs to Medicare beneficiaries are covered under Medicare effective with the date of the clinic’s approval for participation. The facility must be primarily engaged in furnishing outpatient services.  However the services in certain instances can be performed in locations outside of the four walls of the clinic.  There are certain services performed that do not actually qualify as RHC services.  As such, they must be billed to the carrier-meaning the clinic must enroll with the carrier as a “Multi Specialty Clinic."

Enrollment

There are several steps to enroll.

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Medical Review

In order to meet CMS' goal of protecting the Medicare Trust Fund, Riverbend must ensure that we pay the right amount for covered and correctly coded services rendered to eligible beneficiaries by providers.

Redetermination Requests
Reconsideration Requests
Medical Records
Automated Edits

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What's What

For the latest CMS information published visit the Quarterly Provider Updates (QPU)

CMS' latest MLN Matters Articles, products and web-based training visit the MLN Network


Page modified:October 26, 2007