01
Protect your revenue cycle
Reduce coding backlogs, capture supported services, and address coding issues before claims move forward.
XpertCoding for Federally Qualified Health Centers (FQHCs)
FQHC coding is different.
Your AI should know why.
Your team understands the complexity of community healthcare. Your coding platform should, too. Meet autonomous AI built around the clinical, quality, and payer decisions between the note and the claim.
Built around FQHC encounter, payer, and quality workflows.
Medicare PPSFQHC payment codesUDS Reporting context
For your health center's leadership
Keep coding moving.
Keep your team focused on care.
Your health center needs timely coding, accurate claims, and less administrative work. XpertCoding uses autonomous AI to code documented care within your existing EHR workflow, with expert review for cases that need attention.
02
Support your clinicians and quality team
Reduce manual coding work, identify documentation gaps, and capture supported diagnoses and quality codes.
03
Maintain visibility and control
Monitor turnaround, review exceptions, and follow the evidence behind coding decisions.
Federally Qualified Community Health Centers already working with XpertDox
Lone Star Circle of Care
Texas · FQHC
Read the press release
CHP Berkshires
Massachusetts · FQHC
Read the press release
Mountain Park Health Center
Arizona · FQHC
Presbyterian Medical Services
New Mexico · FQHC
Camarena Health
California · FQHC
Mariposa Community Health Center
Arizona · FQHC
Community Health Centers, Inc.
Florida · FQHC
The details are the difference
Built around the way
community health centers get paid.
FQHC billing has its own rules. XpertCoding connects the care documented by your team to supported codes, payer requirements, and reviewable decisions.
01 / CPT & HCPCS
Code the care delivered
Same-day medical and mental health care; AWVs; qualifying visits and bundled services.
02 / The diagnosis
Supported, not assumed
Secondary diagnosis reporting requirements, accurate acuity, SDOH, and linkage to the service performed.
03 / The quality
Capture the care delivered
Blood pressure and A1c results mapped to quality codes, with program eligibility checks.
04 / The claim
The payer matters
77x claim types, qualifying services, revenue codes, and FQHC specific HCPCS codes
01
CPT & HCPCS coding
CPT coding.
Built for FQHC encounters.
Capture the care delivered and apply the appropriate FQHC payment rules.
Start with the CPT code: the E&M level, procedure or therapy supported by the note. Then connect it to the HCPCS payment codes and payer rules that shape an FQHC claim.
levelsProcedures & servicesModifiersHCPCS relationships
Select the supported CPT codes
Evaluate the documented E&M service and procedures. In this example, 99213 and 90832 represent the separately documented medical and psychotherapy services.
Payer Rules
Capture supported services, correct unsupported codes, and retain service detail even when payment is bundled into the encounter rate.
Connect CPT to HCPCS and payer requirements
Pair the qualifying CPT services with G0467 and G0470 in the Medicare FQHC example.
02
ICD-10-CM coding
The whole patient.
The supported diagnosis.
Represent the complexity of your patients with diagnoses supported by the record.
Community health documentation often spans chronic disease, behavioral health, and barriers to care. Capture that complexity without inventing a diagnosis.
Diabetes with documented hyperglycemia
Use the clinician's assessment to select the supported diabetes code. A high lab value alone does not substitute for the diagnosis.
Housing instability with a documented risk
A signed care-team note documents that the patient is housed and at risk of homelessness. The social need is relevant to the current care plan.
Correct the imported complication
The clinician explicitly identifies the old neuropathy entry as an error. Remove that unsupported claim diagnosis and retain the supported findings.
The standard ICD-10-CM code set applies. This example uses the FY 2027 rules for an October 2026 encounter. Read the coding guidelines
03
Quality-metric coding
Claim-level quality.
Health-center reporting context.
Support quality workflows with documented information, and appropriate code capture.
Connect supported quality-code opportunities to payer programs and the health center's reporting team. UDS requirements remain a separately defined reporting workflow.
Eligibility before assignment
Check the applicable patient, visit, timing, and exclusion criteria. Finding a value in the note is the beginning of the review, not the whole decision.
Payer and program context
Keep claim-level quality coding, payer incentives, and reporting programs distinct. Apply the relevant program version and contract context to the opportunity under review.
Connect to the health-center reporting team
HRSA Health Center Program awardees and look-alikes submit UDS data. Preserve the source values and dates that the separately scoped reporting workflow needs.
128/76 becomes two supported code actions.
In this hypertension encounter, the documented reading supports 3074F and 3078F under the illustrated payer reporting workflow. Check both values and prevent duplicate reporting.
BP: 128/76Current encounterPayer accepts3074F + 3078FSource retained
A blood-pressure result with a clear code trail
Record: a 58-year-old patient with hypertension; blood pressure 128/76 mmHg. The configured payer accepts Category II reporting.
3074F + 3078F reflect the documented systolic and diastolic ranges. The demo checks the current encounter, source reading, and duplication before preparing both codes.
Claim-level reporting supports the quality workflow; measure eligibility, exclusions and annual reporting remain separate checks. 2026 payer coding reference
Explore the coding and quality workflows that matter to your FQHC.
04
Billing & payer requirements
FQHC claim lines.
The right payer context.
Prepare claim details around the FQHC rules and payer requirements that apply.
For Medicare, inspect a 77X claim with each FQHC payment code and its qualifying service. For Medicaid, follow the separately labeled Arizona encounter example.
Review the FQHC 77X claim, PPS payment code, qualifying service, and revenue-code relationships in the Medicare example.
Autonomy you can understand
Sophisticated technology.
Practical, reviewable work.
XpertCoding brings autonomous coding together with payer context and reviewable decisions. Your team needs to see the work completed, the cases that need attention and the evidence behind each action.
From clinical documentation
Understand the encounter and the information available.
Through coding and payer context
Bring the applicable requirements into the decision process.
To action, exception, and explanation
Make the result understandable to the team responsible for it.
Business intelligence & documentation improvement
Start with your question.
See where to focus.
See which claims need attention and where documentation can improve.
Connect the coding work to the decisions your revenue-cycle, quality and clinical teams make next.
Results
Faster coding.
Focused human review.
See how quickly coding moves, how much needs expert review and where your team should focus.
Processing time
23hours
From documentation to coding
Time from documentation to coding output.
Manual review
8%
Expert attention where it is needed
Share of encounters routed for expert review.
What would this change for your health center?
In your demo, review your current coding backlog, turnaround and review workload. Use those measures to define the operating goals for your FQHC.
Coding backlog
Which encounters are waiting, and why?
Team workload
Which cases need people, and which can move automatically?
Clinical follow-up
Which documentation gaps need a targeted response?
Review your backlog, turnaround and team workload with XpertDox.
Coding compliance
Expert leadership.
Traceable coding decisions.
Know how coding decisions are checked and who oversees the work.
Documentation support, validation, expert oversight and traceability belong in the same conversation. Follow the documentation, validation and review steps below.
Start with the documentation that supports the action. Review supported additions alongside corrections, removals and unresolved conflicts.
Coding & compliance leadership
Kelly Canter
MHA, RHIT, CCS, CRCR, CPM, FAHIMA
Chief Medical Coding and Compliance Officer
Member, AHIMA Board of Directors
More than 20 years in health information, revenue cycle and technology.
Cybersecurity & continuity
Community healthcare is built on trust.
Review the safeguards that protect patient information and keep coding operations available.
SOC 2 Type 2
Controls and independent examination
ISO/IEC 27001
Information security management
ISO/IEC 22301
Business continuity management
HIPAA safeguards
Patient-information protection
Walk through coding oversight, validation and the decision record.
Implementation
Your EHR. Your workflow.
A connected coding team.
Know what changes for your team, who owns each step and how you approve go-live.
Connect your EHR, validate the FQHC coding decisions and launch with clear ownership. Your team keeps its documentation workflow while XpertDox manages the coding connection, configuration and ongoing review.
Connect with the systems your team already uses.
EHR and practice-management connections include
- Epic
- athenahealth
- eClinicalWorks (eCW)
- NextGen
- Experity
- ModMed
- Centricity / AthenaPM
- Practice Fusion
Using another EHR or PM system? We can scope a custom connection with your team.
See how the data moves.
Choose a connection method, then follow a completed encounter into XpertCoding and back to the working system.
HL7 v2 and ADT messaging
Use ADT messages for patient and encounter context. Configure the accompanying documentation and charge interfaces for the full exchange, including return of coding output to the EHR or PM system.
↩ Back into your workflowReturn coding output through the configured interface
1 / 4
Receive completed documentation
The source encounter brings the signed note, patient and encounter identifiers, documented services and existing coding into the agreed workflow.
- Completed clinical note
- Patient and encounter match
- Existing diagnoses and services
Receive completed documentation…
A clear path from kickoff to ongoing operations.
Select a phase to see the work, the owners and the decision that moves the project forward.
FQHC · 01 · Connect & configure
Build the connection around your workflow.
Map FQHC sites, EHR access, payer enrollment and the relationship between encounter-payment and service lines.
XpertDox
- Map source documentation and the coding return destination.
- Configure the EHR connection, sites, practitioners and payer rules.
- Test field mapping, record matching and exception handling.
Your team
- Name the technical lead and implementation owner.
- Provide approved access, coding guidelines and payer preferences.
- Confirm which EHR or PM fields and work queues will receive output.
A named implementation lead
A shared plan, regular status reviews and clear escalation contacts keep technical and coding work moving together.
Clinical and coding participation
Your designated reviewer and clinical decision-maker resolve questions, approve preferences and provide feedback during validation.
A plan built at kickoff
Confirm milestones after access, interface requirements, documentation and reviewer availability are understood. Connection setup is one part of the full rollout.
Discuss your EHR, service lines and rollout plan.
Hear from FQHC peers
The strongest proof comes from the people doing the work.
Hear how Federally Qualified Community Health Centers describe their experience with XpertCoding.
FQHC partnership
We've cleared our claims backlog, improved our collections, and made our coding much more efficient.
Lone Star Circle of Care
Dr. Tracy Angelocci , Senior Strategic Advisor for Clinical Innovation & Integration, as quoted November 6, 2024.
Read the press releaseFQHC partnership
Our coding team is now able to focus on value-based care initiatives and auditing.
CHP Berkshires
Jesse Suphan , Senior Director of Revenue Cycle & Quality, as quoted November 18, 2025.
Read the press releaseFor the detailed evaluator
The questions behind the decision.
XpertCoding is designed to automate coding work, with exceptions and oversight available to the team. In a tailored demonstration, examine an encounter from documentation through coding, review and claim preparation. The examples on this page are scripted demonstrations.
Built around your health center
Let's work through the scenarios your team knows are difficult.
Less administrative friction. More capacity for the work that matters to your community.
