All You Want To Know About Skilled Nursing Billing Services
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.
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
Other Problems faced by Skilled
Nursing Facilities in Billing
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. With most SNFs being challenged with
the staff and overworking, getting the staff trained can be a challenge, so how
to ensure SNF can thrive?
How To Make The Skilled Nursing
Facility Thrive?
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.
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.
About
24/7 Medical Billing Services:
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.
Contact:
24/7
Medical Billing Services
Tel: +1
888-502-0537
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