Form preview

Get the free Federally Qualified Health Center Look-Alike Guidelines and Application - ftp hrsa

Get Form
This document provides guidelines and application instructions for organizations seeking designation or recertification as a Federally Qualified Health Center (FQHC) Look-Alike, detailing eligibility
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign federally qualified health center

Edit
Edit your federally qualified health center form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your federally qualified health center form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing federally qualified health center online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Follow the steps down below to take advantage of the professional PDF editor:
1
Log in to account. Click Start Free Trial and sign up a profile if you don't have one yet.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit federally qualified health center. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.
4
Get your file. Select your file from the documents list and pick your export method. You may save it as a PDF, email it, or upload it to the cloud.
It's easier to work with documents with pdfFiller than you can have believed. Sign up for a free account to view.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out federally qualified health center

Illustration

How to fill out Federally Qualified Health Center Look-Alike Guidelines and Application

01
Gather necessary documentation including organizational bylaws, governing board information, and detailed service plans.
02
Review the Federally Qualified Health Center Look-Alike Guidelines to understand eligibility requirements and application components.
03
Complete the application form, ensuring all sections are filled out accurately.
04
Provide a comprehensive description of the proposed service area and the population served.
05
Include a financial plan demonstrating sustainability, including budgets and funding sources.
06
Detail the types of services to be offered, focusing on primary care, mental health, and preventive services.
07
Compile letters of support from community stakeholders and other healthcare providers.
08
Review the application for completeness and compliance with guidelines before submission.
09
Submit the application electronically through the designated platform or by mail as prescribed.

Who needs Federally Qualified Health Center Look-Alike Guidelines and Application?

01
Healthcare organizations seeking to provide primary care services in underserved areas.
02
Non-profits and community-based organizations looking to access federal funding for health services.
03
Entities aiming to enhance healthcare access for low-income and uninsured populations.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.0
Satisfied
31 Votes

People Also Ask about

A Federally Qualified Health Center (FQHC) is a community-based health care organization that provides comprehensive primary care and support services to underserved populations in the United States. These centers serve patients regardless of immigration status, insurance coverage, or ability to pay.
FQHCs are overwhelmed by patient volume and struggle to stay ahead of rising risks, since FFS does not incentivize preventive care. As a result, they spend more time and money on treating patients at the high end of clinical complexity, which limits their availability for new patients.
There are compliance requirements to qualify as an FQHC Look-Alike, such as offering a sliding fee scale, having a board of directors for the health center, and being in a federally designated high-need area or demonstrating that they are serving such areas.
RHCs operate exclusively for the purpose of providing primary care services to Medicare patients located in rural and shortage areas; FQHCs provide primary care services and dental care services to rural/urban areas and shortage areas.
As of September 2024, there are 155 Look-Alikes. 12023 Uniform Data System, Bureau of Primary Health Care, HRSA, DHHS. 22022 Uniform Data System, Bureau of Primary Health Care, HRSA, DHHS.
Although they do not receive grant funding, Look-Alikes do receive many of the same benefits as FQHCs, including: Reimbursement under the Prospective Payment System (PPS), in which Medicare payment is made based on a national rate which is adjusted based on the location of where the services are furnished.
FQHCs can receive reimbursement from Medicare under a Prospective Payment System (PPS) and from Medicaid under the Prospective Payment System (PPS) or other state-approved Alternative Payment Methodology (APM).

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Federally Qualified Health Center Look-Alike Guidelines and Application provide a framework for health centers that want to receive the same benefits as Federally Qualified Health Centers (FQHCs) but do not receive federal grant funding. These guidelines outline the requirements and processes for clinics to be recognized as Look-Alikes, ensuring they meet certain standards of care.
Organizations that provide primary health care services to underserved populations and seek to be designated as Look-Alikes must file the application. This includes community health centers, hospital outpatient departments, and other health entities that meet the eligibility criteria.
To fill out the application, organizations need to gather required documentation, complete the application form, and submit it along with supporting materials that demonstrate compliance with the necessary guidelines, including evidence of governance, service delivery, and financial viability.
The purpose of the application is to allow health centers that exist in underserved areas to gain recognition and funding equivalencies without being federally funded, ensuring they can continue providing essential health services to vulnerable populations.
Applicants must report information including their organizational structure, governance, service delivery capability, patient demographics, financial plans, and any existing partnerships. This information demonstrates their ability to meet the health care needs of the communities they serve.
Fill out your federally qualified health center online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.