Skilled Nursing Facility Billing Services Missouri, MO
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
For more than a decade our medical billers have been providing outstanding medical billing solutions to providers in Missouri. Currently, we have medical billers catering to practices in Jackson, Gulfport, Hattiesburg, Biloxi and Southaven.
Our highly qualified staff of medical billers is experienced in billing and successful collection of your claims. Their in-depth knowledge and expertise allows physicians to concentrate on patient care and market their practice. Some of the services, our billers are specialized in:
Charge entry and insurance verification
Accurate entry of CPT and ICD-9 patient coding
Accurate Payment posting
Follow up on primary and secondary claims
Collection of all aged account balances
Customized month report
Medical billing can be considered to be a complicated service in terms of technicality and ever changing regulations, which make it quite difficult to standardize medical billing processes. To bring about some amount of uniformity in the process of billing and coding, the Coding Standards Committee developed new coding standards which also comprise a pool of designated coding and billing professionals. Our local billers and coders in Missouri have kept been following these changes on a regular basis.
These Billing Specialists in Missouri will be able to help your practice cater to all paper based as well as electronic billing, along with the latest fee schedules and payment criteria of Medicare, Medicaid and all commercial insurance.
Our Billers in the state of Missouri 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 Missouri 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 Missouri 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.