Skilled Nursing Facility (SNF) Billing
Streamline your Practice’s Billing with Skilled Nursing Facility (SNF) Billing
Skilled nursing facilities cater to patients who need rehabilitation or other post-hospitalization medical care. Due to the complexity of Medicare billing, SNF billing becomes very technical and crucial, and thus it is managed with a forthright understanding of both the skilled nursing facility (SNF) consolidated billing process and SNF billing guidelines. Accurate implementation of skilled nursing facility billing operations will ensure that claims for all treatments given to the residents under Medicare Part A, such as therapies, medications, and durable medical equipment, are submitted.
Probably the most difficult situation in billing is the complexity of the system integrated within a skilled nursing facility. SNFs bill nearly all their services to their residents during a covered stay, except whenever an exemption may be applicable. Thus medical coding and billing mistakes that impact a facility’s reimbursements and its revenue cycle. Having a sharp follow-through of the SNF billing guidelines will also prevent facilities from delays and claim denials.
Skilled nursing facilities also have to contend with a diverse array of patient conditions that will require special care and treatment, making the billing process much more accurate for effective reimbursements. Every patient’s treatment plan can encompass sessions such as specific forms of rehabilitation, wound care, and hospice, all of which require accurate coding to ensure they are reimbursed properly. It is overwhelming trying to understand the minute differences of each service and its association with the facility expenses. Our billing experts specialize in SNF billing and know the specific codes and regulations that are used to code the different treatment processes. It is our area of expertise, which can allow for maximum optimization of submitted claims, resulting in each service performed having proper, optimized billing that will result in fewer denials and maximum revenue potential for your facility.
By partnering with one of the most experienced medical billing company, you can simplify revenue cycle management. From verifying patient eligibility and accurate coding to submitting claims and follow-through, our team strictly adheres to the medical billing guidelines and manages the billing process of the facility well.
Structured SNF Billing Solutions Includes
Experience in Nursing Facility Billing Guidelines
We stay updated to nursing facility billing guidelines so that every claim is processed in the correct format and is received in full compliance to minimize the risk of denied claims and maximize timely reimbursements.
Nursing Facility Consolidated Service
We manage all aspects of nursing facility consolidated billing, ensuring proper implementation of services under the Medicare Part A benefit. This includes managing ancillary services and preventing unnecessary payment delays.
Claim Submission and Follow-Up
Our process is streamlined in ensuring all claims are submitted within required timelines and to maintain the highest levels of accuracy. We even provide follow-up services, designed to address issues regarding denied or delayed claims, ensuring prompt payment to your facility.
Accounts Receivable (AR) Management
In AR follow-up services, all submitted claims are tracked by our team, meaning that payments owing to the facility are handled on time. Ensure denied claims are resolved immediately to avoid any cash flow fluctuations for your SNF.
Payment Posting and Reconciliation
Ensure all payments are posted out well to have each account reconciled entirely; this ensures no discrepancies exist and financial transparency for your facility is maintained.
Denial Management and Analysis
Our goal is to carefully scrutinize each rejected claim, determine the reasons and corrective actions for such occurrences, and prevent future similar claims. This will prevent and help you minimize revenue loss while maintaining a healthy record in terms of finance at your facility.
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Frequently Asked Questions
1. What is excluded from SNF consolidated billing?
Excluded services from SNF consolidated billing include certain items like physician services, ambulance transportation, outpatient therapy, and some laboratory tests. Additionally, services provided by a non-SNF entity, such as specialized treatments or diagnostic services not covered under the SNF stay, are also excluded. Understanding these exclusions helps ensure accurate billing and reimbursement.
2. What is the difference between a SNF and a nursing facility?
A skilled nursing facility (SNF) provides a higher level of medical care and rehabilitation services, typically for patients recovering from surgery or illness, and is Medicare-certified. In contrast, a nursing facility can refer to a broader range of long-term care settings, including assisted living and residential care homes, which may not provide skilled medical services. Essentially, all SNFs are nursing facilities, but not all nursing facilities are SNFs.