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All You Want To Know About Skilled Nursing Billing Services.pptx
1. All You Want To Know About Skilled
Nursing Billing Services
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Most skilled nursing facilities (SNF) face a double quandary because
first, they have to operate under increasing financial pressure, and
second, there is rising anxiety over staffing and infrastructure. Added to
the Balanced Budget Act of 1998 changes the way SNF reimbursements
are done.
This article will give a comprehensive guide on SNF billing and
problems and how to overcome them.
Challenges of Billing with Skilled Nursing Facilities
For successful reimbursements in SNF claims, one needs to know the
consolidated billing requirements. But that’s not all. The billing staff
needs to have comprehensive knowledge about the codes and the
procedures and facilities covered by Medicare A. Anything that is not
covered will lead to claim denial. But the complexity continues as there
are some benefits which are not covered by Medicare A are covered by
Medicare B. The SNF, in such a case, has to identify the difference and
bill it separately to get paid.
2. All You Want To Know About Skilled
Nursing Billing Services
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3. Problems faced by Skilled Nursing
Facilities in Billing
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The payment on a per diem basis, on the other hand, means CMS pays
a fixed amount to SNFs under Medicare A. In such a case, the SNFs pay
the providers of the contracted nursing services.
To get this payment, the SNF has to follow specific procedures:
For getting paid, SNF has to claim the consolidated billing for
Prospective Payment Systems (PPS)
Medicare A pays the SNFs on a per diem basis
4. Other Problems faced by Skilled Nursing
Facilities in Billing
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Since SNF billing is a complex process, it is exposed to quite a few
problems regarding revenue collection. Some of the situations that lead
to reimbursement for the services rendered are:
Applying incorrect codes for the services, which leads to claim rejection
Staff lacking sufficient knowledge of the services covered by Medicare A
and B
The nursing facility fails to accommodate or understand the cost borne
for the per diem or fixed payment. Since there is a range of elasticity in
the cost of services that fixed rates offer, services often fail to
encompass that, which results in loss of payment
In all the above cases, the SNF exposes itself to revenue leakage. In
one scenario, it is by claim rejection whereas in another, it is by getting
underpaid for the service. Also, the lack of knowledge in how to bill for
services provided by the facility when excessive time is spent with the
patient on non-medical activities means a loss of revenue.
However, all these situations and factors can be mitigated with proper
revenue cycle management software and trained people who can
process all these while having proprietary technology for the facility.
5. How To Make The Skilled Nursing Facility
Thrive?
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There is a rise in the aging population and the demand for skilled
nursing facilities. But many SNFs fail to prosper because of the above
challenges and problems. However, the best way to mitigate them is by
outsourcing the SNF billing services to a third-party organization such as
24/7 Medical Billing Services.
Over the years, 24/7 Medical Billing Services has helped nursing
facilities improve their revenue. The focus of 24/7 Medical Billing
Services has been to reduce claim rejections while helping nursing
facilities to build better services.
24/7 Medical Billing Services, medical coders and billers have extensive
knowledge about the intricacies of SNF billing and coding. As a result,
they take the burden on them to ensure the entire medical billing cycle
runs appropriately. They start with identifying the edibility of the patient’s
reimbursements to separating the Medicate A and Medicare B items, so
the billing is done correctly. The team looking after the SNF billing
system also conducts regular post-claim submission and follows it up to
ensure timely payment for the services done by CMS.
6. Conclusion
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24/7 Medical Billing Services offers a flexible model for the SNF. It allows
them to choose the service that fits them. It also offers in-house SNF
billers and coders through the 24/7 Medical Billing Services portal to the
off-shore location of billers and coders. While the while can dedicate
itself to providing nursing care to the patients, the outsourced team will
work on the entire coding and billing range to ensure on-time payment.
Also, the RCM model offered by 24/7 Medical Billing Services for any
SNF involves an in-depth study of the services revenue cycle
management to identify areas that causes loss of revenue. Also
whenever needed, we help replace the outdated and legacy-based
revenue collection process with the latest software that can be
customized as per the particular SNF’s requirement.
It also helps train the staff to understand the new environment and ways
to get the best out of the outsourced billing management system. Since
SNF, at times, operate differently based on federal and state laws, 24/7
Medical Billing Services has the knowledge to work as per the local and
national network to meet the SNF’s billing and coding requirements.
7. About Us
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We are a medical billing company that offers ‘24/7 Medical Billing
Services’ and support physicians, hospitals, medical institutions and
group practices with our end to end medical billing solutions. We help
you earn more revenue with our quick and affordable services. Our
customized Revenue Cycle Management (RCM) solutions allow
physicians to attract additional revenue and reduce administrative
burden or losses.
8. Contact Us
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Media Contact:
24/7 Medical Billing Services
Georgia
3001 Greenfield Drive, Marietta GA
Ohio
28405 Osborn Road, Cleveland, OH 4414030068
Texas
2028 E Ben White Blvd, #240-1030 Austin TX, 78741
Delaware
16192 Coastal Highway, Lewes, Delaware 19958, United States
Phone no / Fax : +1 888-502-0537
Email us: info@247medicalbillingservices.com