Toll Free 888-357-3226

Skilled Nursing Facility Billing Services New Jersey, NJ

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 medical billers and coders stationed in New Jersey, provide physicians with the latest in reimbursement strategies and government updates in terms of healthcare industry. Their presence across all major cities such as Newark, Jersey City, Patterson, Elizabeth and Edison offer Physicians options to locate well trained Medical Billers and coders easily.

These medical billers are equipped to reduce your overhead as well as perform complex administrative tasks. Their services guarantee many advantages and can help you to:

  • Reduced overheads
  • Patient eligibility verification in real time
  • Expedite payments
  • Reduction of rejected claims but follow up on them as well
  • Increased productivity of in-house team
  • Collection of overdue claims

The state of New Jersey happens to be the most densely populated and wealthiest state in United States, those are the real indicators of why healthcare is sprawling in the state. Thus, the growing need for number of physicians and a lot of medical billing specialists to support these practices is far from being fulfilled.

These Billers are well acquainted with the payers’ community in New Jersey and track major reasons for denials and plug these avenues of revenue loss first. Their detailed analysis helps you to collect more revenue as per your specialty and maintain high collections regularly.

Value Our New Jersey Billers Bring :

Our New Jersey medical billers and coders also provide practice management software that ensures that physicians can keep up with the latest health care IT reforms and improvements. They are experienced in the field of patient statements processing, claims management, fee schedules evaluation, insurance collections, and the capability of establishing effective relationships with insurance companies and patients.

Our medical billing and coding team is experienced in insurance collections which can be a tiresome job for a medical biller who lacks experience in this area. They also know how vital timely insurance collections are for the doctors.

By using EMR software that is efficient, our medical billers and coders take minimal amount of time for patient statement processing which can be an increasing burden because of the growing requirement for medical services.

Medical coders and billers at medicalbillersandcoders.com also have professional relationships with key insurance companies across New Jersey so that any setback or errors in claims management can be circumvented in right in the beginning.

Our Specialties:

The services of medical coding and billing that are provided are not limited to big cities such as Newark, Jersey City, Patterson, Elizabeth and Edison but also all other counties in the state. Moreover, our coders and billers specialize in all the branches of medicine such as Optometry, chiropractic, OB Gyn, Pediatrics, oncology, urology, Family Practice 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 and health care providers. Many of our medical billers and coders also offer value added services through specific services such as evaluating fee schedules, helping you prepare online super bills and diagnosing the key grounds for denials.

Our Software Experience:

In New Jersey many physicians are finding it a difficult to digitize their practice and switch to EMRs which would be part of the health care reform. Our medical billers and coders are specialized and experienced in a wide range of software which offers you a choice of the most efficient and updated Medical Billers and coders trained on the latest EMR systems in the market.

These include Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity and Altapoint. These EMR would ensure that your office productivity is increased along with the efficiency of the services that you provide as a physician to your patients.

Problems New Jersey Physicians Face :

New Jersey has the highest density of population in the United States and the low rate of physicians who are starting to adopt Electronic Medical Records would mean that health care providers would be scrambling to meet the adoption deadlines.

The billing and coding services assist physicians with various EMRs and are experienced with specialized knowledge about the changes related to medical billing, coding, HIPAA guidelines, denial management, patient statement processing, claims management and ability to have long term and effective relationships with patients and insurance companies.

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.