Converting a doctor's office into a Rural Health Clinic (RHC) involves several steps and compliance with specific federal and state regulations. Here is a general outline of the process:

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1. Eligibility Requirements: Ensure the clinic is located in a non-urbanized area as defined by the U.S. Census Bureau. - The area should be designated as a Health Professional Shortage Area (HPSA) or a Medically Underserved Area (MUA) by the Health Resources and Services Administration (HRSA).

 

2. Compliance with RHC Regulations: The clinic must meet certain staffing requirements, including having at least one nurse practitioner (NP) or physician assistant (PA) available to provide services at least 50% of the time the clinic is open. - The clinic should provide outpatient primary care services, which include basic lab services.

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3. Application Process: Submit an application to the Centers for Medicare & Medicaid Services (CMS). This includes the Form CMS-29 (Rural Health Clinic Application Form), and potentially additional state-specific forms. - Develop and submit policies and procedures that comply with RHC requirements.

 

4. Certification and Inspections: After the application is submitted, a state survey agency or accrediting organization will conduct an on-site survey to ensure compliance with federal RHC regulations. - The clinic must pass this survey to receive certification as an RHC.

 

5. Reimbursement System: Understand the cost-based reimbursement model for RHCs under Medicare and Medicaid, which differs from standard fee-for-service payments. This requires accurate cost reporting and accounting practices.

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6. Continuous Compliance: Maintain compliance with RHC standards and participate in periodic recertification surveys. - Stay updated with any changes in RHC regulations and guidelines.

 

7. Additional Steps: Secure necessary funding or financing for any required renovations or expansions. - Train staff on RHC operational and billing practices.

 

It's advisable to consult with our experts at Healthcare Revenue Services who specialize in assisting clinics through the RHC certification process. This ensures that all steps are thoroughly addressed and the transition is as smooth as possible.