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Specialized Billing for Skilled Nursing Facilities (SNF)
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
SNF & Nursing Home Billing Services We Offer
You specialize in patient rehabilitation and nursing care, while we specialize in revenue recovery. Let’s team up for financial success! The billing process for nursing homes and skilled nursing facilities (SNFs) is more complicated than other specialties. It includes meeting the unique demands of government programs like Medicare and Medicaid and private insurance payers. You must also seamlessly adapt to the ever-changing Patient-Driven Payment Model (PDPM) for consolidated billing for skilled nursing facilities.
Our expert nursing home billing and skilled nursing facility billing services address these problems! Since, under PDMP, payments are based on patient needs instead of therapy minutes, we maintain proper records and ensure accurate coding. Our revenue management solutions for nursing homes and SNFs include everything from error-free billing and coding to AR recovery and denial management.
Common SNF & Nursing Home Medical Billing Challenges
Is your nursing home or skilled nursing facility also struggling with high denial rates like many others? All nursing care centers in the country are in peril. It is quite difficult for many caregivers to secure proper reimbursements for post-acute care services or custodial care, especially with some Medicare Advantage insurers using pre-authorization as a cost-cutting tool. Additionally, complex payer systems and changing regulations make it hard to maintain compliance.
So, how can you effectively bill your services under constant scrutiny? You start by understanding the common challenges that derail the SNF and nursing home medical billing workflows.
Varying Payer Policies
The biggest challenge for SNFs and nursing homes is to deal with multiple insurance payers. Medicare may be the primary payer for post-acute care, but many patients still rely on private insurers. Each payer has a unique policy for nursing care services, making the reimbursement and follow-up processes more difficult.
Consolidated Billing Challenges
Another significant challenge for SNFs and nursing homes is effectively billing multiple services under one bill—consolidated billing within the prospective payment system (PPS). This system is prone to human errors, including coding mistakes and confusion over bundled services, which can lead to claim denials and revenue loss.
Lack of Skilled Workforce
The billing process for nursing homes and skilled nursing facilities is already quite complex. Unfortunately, many nursing care practices struggle with a shortage of skilled billing teams. This results in errors in eligibility verification, inaccurate claim submissions, and improper management of claim denials.
AR Management
Aging accounts receivable (AR) eventually results in bad debt and increased financial strain. Many skilled nursing facilities and nursing homes have depleted resources because they struggle to resolve claim denials and collect payments on time. This impacts their quality of care and operational efficiency.
Benefits of Outsourcing SNF & Nursing Home Billing
Trying to overcome the complexities of consolidated billing? Let’s help you manage these complications! Billing services rendered at skilled nursing facilities and nursing homes is not only difficult but also quite different. PDMP compliance, bundled payments, and payer- and state-specific regulations can challenge even the most experienced in-house billing teams.
That’s where MediBillMD comes in! We specialize in SNF and nursing home medical billing, simplifying your financial operations. Our dedicated billers and coders take your problems seriously and manage everything, from insurance coverage verification and accurate coding to claim submission and follow-ups, to collect your payments as soon as possible. You can get a range of benefits by outsourcing SNF and nursing home billing services to MediBillMD.
Achieve unparalleled success with our expertise! At MediBillMD, we expertly manage the perplexing requirements of nursing home and skilled nursing facility billing. This includes accurate coding, complete documentation, appropriate bundling, and compliance with the Patient-Driven Payment Model (PDPM). Moreover, our team files timely claims to avoid denials.
Reduce the risk of bad debts! At MediBillMD, we have a rigorous process to confirm every patient’s insurance eligibility for short-term rehabilitative or long-term custodial care. Our team reviews every patient’s insurance plan and even directly contacts different payers to minimize your financial losses and out-of-pocket expenses.
Provide high-quality care to your residents and avoid hefty fines! At MediBillMD, we understand how overwhelming it is to stay updated with every payer’s policy. Therefore, our team efficiently handles regulatory compliance so you can focus on patient care while avoiding financial or legal penalties.
Track your performance and improve your billing practices! Transparency is one of our core values. Hence, at MediBillMD, we provide regular reports on your SNF or nursing home’s billing performance so you can know the status of your claims, electronic payments, or appeals.
Experience our expertise in state-specific SNF and nursing home medical billing anywhere in the country! At MediBillMD, we simplify billing for all types of nursing homes and SNFs across all 50 states. So, whether you run a skilled nursing facility in California or provide long-term supportive care in Florida, contact us to acquire SNF or nursing home medical billing services and optimize your revenue cycle.
Overcome SNF & Nursing Home Billing Challenges with MediBillMD
Want to bridge the gap between care and cash flow? Outsource your nursing home and skilled nursing facility billing to MediBillMD! Our exclusively customized billing solutions guarantee accuracy, compliance, short turnaround, and complete reimbursements. With our assistance, you won’t have to worry about aging AR, eligibility verification issues, or high denial rates. Here is how we solve the most common billing challenges.
| Common SNF & Nursing Home Billing Challenges | MediBillMD Solution | |
|---|---|---|
| Compliance with PDPM Regulations (e.g., incorrect case-mix classification—grouping residents with differing conditions together) |
Our coding and documentation practices align with PDPM regulations. This includes documenting patients’ characteristics and the care provided. | |
| Consolidated Billing Confusion (e.g., bundling separately payable physician’s professional services with therapy services) |
We review every payer’s policy to identify bundled items and separately billable services. | |
| Skipping Eligibility Verification (e.g., billing Medicare for long-term non-covered services) |
We have a rigorous insurance eligibility verification process. Our team performs real-time insurance verification for every patient. | |
| Aging AR (e.g., claims unresolved for over 100 days due to missing or incorrect documentation) |
We recover your aging AR. Our team proactively follows up on submitted claims and submits additional documents on time. | |
| Ignoring Coding Updates (e.g., still using the deleted CPT code 99318 to bill for the annual nursing home exam) |
Our AAPC-certified coders keep up with the annual updates to ensure accurate coding | |
Lowest Prices Guaranteed
Do your billing costs outweigh your reimbursement collections? Partner with MediBillMD to acquire tailored SNF and nursing home billing services without blowing your budget. Keep your revenue flowing with our guaranteed lowest rates!
Get in Touch with a
Nursing Home Billing Expert
Need a quick solution for ever-changing payer-specific policies and PDPM regulations? Call us to schedule an appointment with our SNF and nursing home billing experts. Communicate your issues, and let us help you improve your revenue.
FAQs
At MediBillMD, we believe in utilizing industry experience and expertise to overcome unique challenges at the lowest possible costs. Our nursing home billing specialists work day and night and follow federal/state laws, coding guidelines, and payer policies to increase your bottom line and prevent revenue leakages.
You can get our proven nursing home billing services for a small percentage of your total monthly collections.
Medical coding for charge capture is the most challenging part of nursing home billing. A range of services are offered to injured, recovering, or elderly patients at nursing homes and skilled nursing facilities (SNFs). Hence, the codes from several categories and coding systems must be compiled to accurately report the procedures/services for clean claims submission.
