MBS for Physicians
Skilled Nursing Facility
Billing Services
Optimize Your Practice Revenue & Billing Efficiency
Getting Started
Handling the financial operations of a Skilled Nursing Facility (SNF) demands accuracy, adherence to regulations, and a clear understanding of long-term care billing nuances.
Our billing services for SNFs are designed to address these complexities, ensuring precise claims, timely payments, and minimizing administrative burdens. By managing Medicare and Medicaid requirements and ensuring compliance, we help nursing facilities optimize their operations and maintain a focus on providing excellent care. Let us handle your SNF billing while maximizing your revenue opportunities.
Medical Billing At A Glance
Explore the key performance metrics that reflect our dedication to accurate coding, reduced denials, and maximized reimbursements for healthcare providers.
Claims Processing Metrics
First Pass Resolution Rate
Percentage of claims paid successfully on first submission.
Average Days to Payment
Average number of days it takes for claims to be paid, typically within 21 days.
Financial Metrics
Net Collection Rate
Percentage of total charges collected successfully.
Denial Resolution Velocity
Average number of days taken to fix and resolve a denied claim, typically within 30 days.
Operational Metrics
Average Monthly Claims
Volume of claims submitted.
Staff Productivity Rate
Claims processed per biller per day.
Skilled Nursing Facility Billing Services
Driving Claim Accuracy and Compliance for Enhanced Revenue Outcomes
The Balanced Budget Act of 1998 made Skilled Nursing Facility (SNF) billing more complex, especially with the Prospective Payment System (PPS) and consolidated billing requirements. Key challenges include:
Medicare Coverage Complexity: Distinguishing between Medicare Part A and Part B services, leading to potential errors.
Fixed Per Diem Payments: Medicare A’s per diem payments often don’t cover full service costs.
Revenue Leakage: Errors in coding and service identification result in claim denials and underpayments.
Under the Prospective Payment System (PPS), Skilled Nursing Facilities (SNFs) are reimbursed by Medicare Part A on a fixed daily per diem rate, which must cover all patient services. The shift to consolidated billing requires all services provided during a patient’s stay to be bundled for reimbursement. Billing requirements include:
Consolidated Billing: All services must be submitted under a unified billing system.
Accurate Service Identification: It’s essential to identify which services are covered under Medicare A and B.
Balancing Fixed Payments and Actual Costs: The per diem rate might not fully cover the range of care required by patients.
Billing errors and a lack of understanding of Medicare’s rules can lead to significant revenue loss for nursing facilities. SNFs often experience claim rejections or underpayments, both of which negatively impact their finances. The main causes of revenue leakage include:
Claim Rejections: Coding mistakes often result in claim denials, which delay reimbursements.
Service Underpayment: The fixed daily rate may not cover the true costs of care.
Service Justification Issues: Proving the necessity of certain services can be a complex, time-consuming task.
The detailed nature of Skilled Nursing Facility (SNF) billing demands a specialized understanding of Medicare’s guidelines and coding practices. A thorough comprehension of these processes is essential to reduce errors, prevent claim denials, and enhance reimbursement rates. Key factors to be mindful of include:
Medicare A & B Understanding: Knowing the coverage limits for each is vital for correct billing.
Expert Coding Skills: Applying the correct codes to ensure comprehensive billing.
Adherence to Regulations: Keeping up-to-date with the ever-changing Medicare policies and regulations.
Medical Billers and Coders offers comprehensive Skilled Nursing Facility billing services designed to address the specific needs of nursing facilities across the U.S., especially in rural areas where a large number of SNFs are located.MBC’s services include:
Complete Billing Cycle Management: From patient eligibility verification to claim submission and follow-up.
Experienced Billers and Coders: MBC’s experts are familiar with the billing intricacies of Medicare and Medicaid, ensuring accurate claim submission.
Post-Claim Submission Support: MBC provides follow-up services to ensure that claims are reimbursed in a timely manner.
MBS understands that each Skilled Nursing Facility has specific needs. We provide various service models that can be tailored to different operational setups, offering flexibility and scalability. The service models available include:
In-House Service Model: Nursing facilities can recruit billers and coders through MBS’s job portal for in-house billing management.
Outsourced Billing Model: For those without an in-house team, MBS’s outsourcing solution manages all billing processes, from insurance verification to follow-up after submission.
Revenue Cycle Management (RCM) Consulting: MBS helps identify potential revenue losses, streamline workflows, and offer recommendations for software or training enhancements.
Partnering with MBS for Skilled Nursing Facility billing services provides several benefits that directly impact your bottom line, helping to improve revenue and reduce administrative burdens. Advantages of outsourcing to MBS:
Reduced Claim Rejection Rates: With expert billers, claims are processed accurately, reducing rejection rates and improving reimbursement.
Improved Revenue Cycle Efficiency: MBS optimizes billing workflows, ensuring that claims are processed in a timely and efficient manner.
Compliance Assurance: MBS ensures your billing processes meet Medicare and Medicaid requirements, reducing the risk of non-compliance penalties.
MBS’s extensive network of professionals across all 50 U.S. states means that we provide not only national expertise but also local knowledge. This allows us to understand the specific needs of your facility based on its location and ensure compliance with state-specific regulations. Local expertise ensures:
Tailored Billing Services: MBS tailors its services to meet state and location-specific requirements.
Familiarity with Regional Challenges: We are well-versed in the unique challenges faced by rural and urban SNFs, providing personalized solutions to each.