SEMO Health Network is proud to be your Federally Qualified Health Center (FQHS). A Community Health Center is just that, a health center based in the community. The FQHC is a federal designation from the Bureau of Primary Health Care (BPHC) and the Center for Medicare and Medicaid Services (CMS) that is assigned to non-profit or public health care organizations that serve insured patients, uninsured patients, private pay patients or medically underserved populations.
FQHCs are specifically located in an area that is designated as a Medically Underserved Area/Population (MUA or MUP). FQHCs provide their services to all persons regardless of ability to pay, and charge for services on a Board approved sliding-fee scale that is based on patients’ family income and size.
Because they receive funds from the Federal government, all FQHCs must operate under a consumer Board of Directors governance structure, and provide comprehensive primary health, oral, and mental health/substance abuse services to persons in all stages of the life cycle. FQHCs must comply with Section 330 program expectations/requirements and all applicable federal and state regulations.
Continuous Quality Improvement
SEMO Health Network demonstrates its commitment to providing the highest quality of care to patients through the implementation of its Continuous Quality Improvement initiative. The quality compliance department is a distinct unit within SEMO Health Network with primary responsibilities in four key areas: patient safety, risk management, quality assurance and regulatory affairs.
- Facilitation of Continuous Quality improvement (CQI) committee
- Implementation of Safety Committee program including:
- Incident Reporting
- Root Cause Analysis
- Failure Mode and Effects Analysis
- National Patient Safety Goals
- Education and Awareness
- Coordination of quality and performance improvement initiatives
- Quality Reviews
- Quality indicator monitoring, benchmarking and reporting to regulatory entities
- Coordination of regulatory compliance
- Management of Infection Control Processes
- Clinical data analysis
- Technical support and education on quality and patient safety issues
- Policy and Procedure development and oversight
- Risk assessment
In accordance with the No Surprises Act, uninsured and self-pay patients are eligible to receive good faith estimates regarding the cost of their medical, dental, and behavioral health care upon request. Uninsured and self-pay patients are defined as:
For GFE purposes, a person is considered uninsured or self-pay — and therefore is eligible to receive a GFE– if they meet any of the following:
- They have no insurance.
- They have insurance, but it does not include coverage for the service they are seeking. (e.g., they have medical coverage only and are inquiring about a dental service)
- They have a short-term, limited duration plan.
- They are “self-pay”, meaning that they have insurance, but plan to pay for the service entirely out of pocket and not submit the claim to their insurance company.
Under the regulatory language, a person is considered “self-pay” if they:
- have insurance coverage for the service (even if they have not yet met their deductible)
- do not plan to file a claim for that service with their insurer.
FOR MORE INFORMATION, PLEASE SEE CLINIC STAFF.