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Skilled Nursing Facility Billing Services Florida, FL

Until 1998, nurse center billing was quite an easy thing to do since skilled nurse facilities (SNFs) could bill separately for their service. Since 1998, after the Balance Budget Act came into effect, several things about how SNFs claim their reimbursement have changed. The points below will outline the changes:

Challenges of Skilled Nursing Facility Billing

Producing SNF claims as part of consolidated billing requires the knowledge of codes as also familiarity with what is covered by Medicare A and what’s not. If something is not covered by Medicare A, then it may be covered by Medicare B. The SNF has to identify that and bill it separately.

On the other hand, payment on per diem basis means a fixed amount CMS pays to SNFs under Medicare A with which SNFs pay contracted nursing service providers for their services.

  • Now SNFs have to produce their claim as part of consolidated billing under the Prospective Payment System (PPS)
  • SNFs are paid by Medicare A on a per diem basis

Our Florida billing service can help you to increase your revenue with the reduction in the number of denied and unpaid claims. Our billers present in all the major cities like Jacksonville, Miami, Tampa, St. Petersberg and Orlando can provide you with less paperwork and more accurate medical claims to improve the efficiency of your practice. Here are some of the services which our billers have shown their proficiency in:

  • Claims are processed on the same day
  • Analysis of accounts receivables
  • Weekly as well as monthly reports on productivity
  • Analysis of codes and procedures on a regular basis
  • Review of fee schedules for updates

Our billers in Florida have been tracking the rate of reimbursements which has been dipping in the state past a decade. They also have analyzed the solution to this dip, the answer lies in the state of Florida’s reimbursement statutes itself. These local Florida billers are the key to unlock blocked cash flows and can provide you with updated methods to improve the efficiency of your practice.

Value Our Florida Billers Bring:

The Florida medical billing and coding services that we provide are not just limited to cities such as major cities like Jacksonville, Miami, Tampa, St. Petersberg and Orlando. They also extend to almost all other towns and smaller cities in Florida. These medical coders and billers surpass HIPAA compliance and are also trained in preferred language such as Spanish. They have been recommended in their past engagements for their medical billing administrative skills, excellent Data Entry management, along with good written and oral communication skills.

Our medical billers and coders in Florida at medicalbillersandcoders.com perform specialized tasks such as reviewing encounter forms for accuracy in ICD-10 and CPT coding, maintain records of existing billing and coverage rules, posting charges and payments to accounts, make follow up calls to insurance companies to resolve any inconsistency in payments and to patients whose accounts were past due to set up a payment plan, report to physicians regularly, offer customer support by comprehending and elucidating insurance EOBs, co-pays, co-insurance and deductibles to patients and enter and revise patient demographics.

Our Specialties:

Florida medical billing specialists can not only assist in increasing your income but also guarantee suitable reimbursement, provide medical billing and coding services in specialties including Otolaryngology, Primary Care, Optometry, Family Practice, Hospitalist Billing, Cardiology, OB Gyn, Physical Therapy, Pediatrics, Internal Medicine, and Dental.

Our Software Experience:

Physician shortage would always be a problem in Florida and is not only affecting doctors but also bigger hospitals, hospices, nursing homes, nurses and resident doctors. The shortage would mean long working hours and more accurate medical coding and billing practices. However, implementation of EMRs is proving to be of immense help since most of the paperwork is diminished and doctors have real-time information about patients and other related data. Our coders and medical billers are expert in software such as Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity, and Altapoint.

Difficulties & Challenges Florida Physicians Face:

One of the unique challenges that physicians and healthcare provides face in Florida is dealing with Florida Medicaid Institutional Care Program (ICP) patients. This is because Florida has a large elderly population (65 years and older) which is projected to grow nearly to 26% of the state’s total population which is the highest among all states in the US.

The fact that these elderly patients are either disabled or are fighting chronic illnesses makes them frequent visitors to physicians’ offices and various hospitals. This fact coupled with the recent health care reform would ensure that health care providers would be required to ensure accuracy and compliance with legal guidelines in order to avoid a drop in revenue or negative legal repercussions. Our medical billing specialists ensure that problems such as inadequate reimbursement due to claim denial and other related factors do not take its toll on your practice.

Our medical billers and coders at medicalbillersandcoders.com can ensure an improvement in the efficiency of your practice by employing the best methods of optimally using your EMR, their exposure of various Practice Management Systems also provides greater collections for your practice.

Nursing Facilities are exposed to the below problems-

  • Inaccuracy of codes applied leading to rejection of claims
  • Insufficiency of knowledge of items covered by Medicare A and B
  • Fixed or per diem payments for services not accommodating cost borne by the nursing facility adequately - given that there is a degree of cost elasticity in the range of services offered by facilities, which the fixed rates often fail to encompass

The above two scenarios expose nursing facilities to two kinds of revenue leakage: one is via rejected claims; another is through underpayment of services.

Additionally, it’s often difficult to establish that the patient required the services provided by a nursing facility and excessive time spent on non-medical activities.

Outsourcing Skilled Nurse Facility Billing to MBC

MBC has helped nursing centers both in rural and urban US (more in rural as that’s where nursing facilities are mostly concentrated) across all 50 US states, to improve their revenues by reducing reimbursement rejection rates and increasing their focus on nursing services. MBC’s billers and coders come with extensive knowledge of billing and coding intricacies so that they can take care of the entire cycle of billing and coding needs starting from identifying patient eligibility for reimbursement to accurately separating items covered by Medicare A and Medicare B. They also perform post-claim-submission follow ups to ensure timely reimbursement of payments by CMS.

Our flexible service models ensure that you can choose a solution that fits your needs and setup. We offer varied service models including in-house service model; where providers can source in-house skilled nursing facility billers and coders through the MBC job portal.

If you don’t have an inbuilt team of billers and coders nor any need to have one, our outsourced billing and coding model will suit you helping you to ship out all your billing and coding responsibilities to us, so that you can solely concentrate on delivery of nursing care. Our outsourcing model includes the entire range of billing and coding activities starting from identifying insurance eligibility of the patient to submission of claims and post submission follow ups.

Our RCM consulting model involves a thorough study of your revenue management cycle to spot areas of revenue leakage and plug them by helping reduce outdated or cumbersome processes, and assist in replacing inept software applications with new ones customized to your need and environment along with help in training people where required.

MBC’s national network also comes with local knowledge and familiarity so that we understand your operating environment and help you meet your state-and-location specific needs.