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How do I become a Rural Health Clinic (RHC)?

Missouri has had great success with the Rural Health Clinic (RHC) Program; however, it is important that you obtain appropriate advice and counsel from individuals with experience and knowledge in the area of the RHC Program before you convert to ensure that this is the best option for your facility.


In order to qualify for RHC status, your clinic must be located in a U.S. Census non-urbanized area and a health care shortage area designated within the last three years. Once you have determined that the site meets the location criteria, you should then conduct a financial feasibility analysis.


While the Rural Health Clinics Program provides an opportunity for enhanced reimbursement, it is important that you consider the other implications that the conversion may have on your clinic. For example, if the current practice does not employ a Physician Assistant or a Nurse Practitioner, then any increased revenues from becoming a RHC might be offset by that additional expense.


When you've determined that conversion will be financially feasible, you will need to contact the Missouri Department of Health & Senior Services to complete an application form. You will also be required to complete the CMS 855A Federal Health Care Provider/Supplier Enrollment application. Before the initial certification, the state will perform an extensive onsite survey. The clinic will then need to be recertified periodically on a schedule determined by the state.


Finally, after receiving the Medicare Provider Letter, the clinic is eligible to file a projected cost report and have their Medicare Rate determined. It is important to get expert advice regarding the cost report as its accuracy can have a significant long-term financial impact on the clinic.

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