Skilled Nursing Facility Billing Services Georgia, GA
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
With a vast experience in medical billing and coding, our Georgia medical billers accommodate physician’s individual needs and provide value added services. They have more than 10 years of medical billing experience and have provided back office operations like billing and collections to physicians in major cities like Atlanta, Augusta, Columbus, Savannah and Athens and also are updated with the ever changing rules and regulations in billing. They have proven their expertise in billing functions like:
Electronic and paper claims submission
Follow up on denied claims
Usage of CPT, ICD-9 and HCPCS codes
Tailor made monthly financial report
Accounts receivables management
Our billers in Georgia have significantly decreased the number of denied claims and also decreased the amount of days it takes to receive payment either from your patients or from the insurance payer. They can take care of the complexities that befall in the billing process like rejected claims, past due accounts and at the same time send invoices to patients, thus streamlining your medical billing process.
Physicians in Georgia are already aware of the shortage of physicians in the state and one of the best ways to attend to it is focus on patient care while experts focus on your billing.
Our Billers in the state of Georgia are specialized to service medical practices as per the regulations of the state government. Their knowledge and experience has been acquired by years of efforts in perfecting medical billing procedures which they now leverage to help your practice collect more revenue.
The federal government’s effort to reduce healthcare cost can only be supported by physicians in the state of Georgia by optimizing costs and enhancing revenue. Letting a specialist handle your medical billing can help you improve collections by 20%.
Accurate Coding and code audit along with timely insurance follow up and account receivables are the basis on which thesebillers in Georgia guarantee higher profitability for your clinic. Their experience in various software and certification in the medical billing processes will support your practice to grow steadily.
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.