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Skilled Nursing Facility Billing Services Nevada, NV

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

The physicians in the state of Nevada have been serviced by the most efficient medical billers, coders and accounts receivables specialist for a decade now. They employ the latest technology and personalized services so as to ensure that physicians in cities such as Las Vegas, Henderson, North Las Vegas, Reno and Paradise receive appropriate compensation for the services provided.

With the ever changing nature of the healthcare industry, our medical billers and coders have experience in handling problems first and work closely with your staff to make your practice realize its full potential. Some of the functions of medical billing which our billers provide are:

  • Patient demographics, registration and charge entry
  • Coding with CPT, ICD-10 and HCPS coding
  • Electronic claims transmission
  • Accounts receivable management
  • Payment posting
  • Reports on a monthly basis

Our medical billers and coders stationed in Nevada have worked with all payers and have the experience to guide your practice through the highest compensation while providing highest quality of care. They manage some of the highest payers such as Aetna, Assurant Health, BCBS of Nevada, Humana Insurance Company and United Healthcare.

Value Our Nevada Billers Bring :

Experienced in insurance collections, which can be a tedious job, is performed efficiently by our medical coders and billers compared to someone who lacks experience in this area. They also know how important well-timed insurance collections are for the doctor as well as the patient. By using Electronic Medical Record that is competent, our medical billers and coders are speedy in patient statement processing which can be a rising encumbrance because of the increasing demand for medical services. Our medical coders and billers at medicalbillersandcoders.com also have solid relationships with key insurance companies all over the nation and the state so that any setbacks or mistakes can be avoided when dealing with insurance matters such as revenue cycle management and in claims denial.

Billing and coding services offered by our billers and coders are a combination of specialized professionals with wide ranging talents such as patient statements processing, fee schedules evaluation, claims management, insurance collections, and the ability to establish effective relationships with patients and insurance companies and know-how of patient accounting software . With exhaustive comprehension of the medical billing and coding and observance of HIPAA guidelines that our coders have, it would become easier for physicians to make sure that income and quality of patient services is not affected due to mistakes in medical coding and billing.

Our Specialties :

They also specialize in various branches of medicine as far as medical billing and coding services are concerned and some of the areas of expertise include Optometry, Family Practice, chiropractic, OB Gyn, Physical Therapy, oncology, Pediatrics, urology, and Hospitalist Billing. All the medical billers and coders at medicalbillersandcoders.com are familiar with ICD9 and CPT Coding which make them preferable choices for physicians.

Our Software Experience :

Our medical billing and coding services provide physicians all across Nevada with efficient EMR software such as Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity, and Altapoint. These can ensure that physicians and hospitals get quick reimbursements and do not have through go through a lot of paperwork.

Difficulties & Challenges Nevada physicians Face :

Nevada is a state that has more than its fair share of problems as far as health care is concerned since it is one of the worst ranked for doctor-patient ratio. This means that physicians and health care providers including emergency clinics are facing patients en masse and this deluge will increase with the health care reform law is completely implemented.

Physician shortage being an enormous difficulty in Nevada, the increasing number of patients in the future would mean requirement of knowledgeable and skilled medical billers and coders. Furthermore, lesser claim denials could be likely due to the health reform which makes it vital that you have a perfect and professional team of medical billers and coders. Our expert medical billers and coders are efficient in quality revenue cycle management services across almost all the counties and cities in Nevada and not just large cities such as Las Vegas, Henderson, North Las Vegas, Reno and Paradise.

This state also faces numerous other challenges which often result in negative repercussions for physicians and other health care providers. These challenges include high unemployment, and high number of elderly population. Our medical billers and coders can efficiently assist doctors and health service providers by providing services such as insurance collections, patient statements processing, claims management, fee schedules evaluation, and the capability to establish effective relationships with patients in addition to insurance companies and skill in patient accounting software.

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.