Skilled Nursing Facility Billing Services Oklahoma, OK
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 Oklahoma medical billers and coders can ensure that your facility gains a steady growth through proper medical billing and claims management processes. They offer effective medical billing solutions for every kind of practice, physician groups, clinics as well as hospitals.
Our medical billers dynamically operate through all major cities such as Oklahoma City, Tulsa, Norman, Lawton and Broken Arrow. They provide customized billing solutions, are adept in handling core medical billing issues and provide services such as:
Accurate submission of claims which leads to improved cash flow
Accounts receivable management
Follow up on denied and rejected claims
Physician credentialing if necessary
Reduction in over all costs
Most of healthcare in the state of Oklahoma is covered by the federal government’s initiative to have affordable healthcare for all. Handling various payer requirements and keeping oneself updated is not easy. Medical Billers and Coders in our consortium would go out of their way to update themselves and the practice they work for.
Value Our Oklahoma Billers Bring :
The presence of Certified Medical Reimbursement Specialists (CMRS) among our billers also means that the claims paying process is smooth and you receive professional services including ICD10, CPT4 and HCPCS Coding, Medical Terminology, Insurance claims and billing, appeals and denials, fraud and abuse, HIPAA, OIG Compliance, information and web technology, and reimbursement.
The presence of certified and professional billers and coders means that you would not only get the best services in this field but also increase your revenue and quality even under increasing work pressure. Moreover this expertise and certification ensures better transparency and offer options which integrate without a glitch with your practice’s processes and not necessitate major changes or realignment in your practice.
Our billers use accurate CPT and ICD-10 codes which help in enhancing your revenue and reduce errors leading to denials. The in-depth knowledge of the latest health care reforms and practices makes our billers more efficient and productive compared to novices in this field.
In Oklahoma about 40% of medical billers and coders work in Oklahoma City but our billers can provide services to health care providers in other cities such as Tulsa, Lawton, Edmond, Enid, Stillwater, Midwest City, Moore and almost all other cities and smaller towns.
With such a wide variety of choices and specialties, our medical billers are capable of customizing according to your need without comprising quality. These medical billers and coders are Certified Professional Coder and some of them even have CCS certification. These certifications enable our coders and billers to keep up and comprehend the changing health care requirements. These certifications also enable physicians to trust their years of experience while making sure they are taking efforts to update themselves. Moreover, sometimes these billers and coders also offer consultancy as a value added service.
Our Specialties :
These Billers are experts in Denial Management, they specialize in account receivables as they understand the reasons for denials and try to prevent them right in the beginning. Moreover, our billers have more than two decades of experience in specialties such as behavioral health and anesthesiology.
Our Software Experience :
Our billers and coders are not only HIPAA compliant but also possess various software skills needed for Electronic Medical Billing and Coding. These include Medisoft, Misys Tiger, Eclinicalworks,Advance MD, GE Centricity, and Altapoint. Such software can be used in medical fields such as emergency room departments, home health care agencies, and hospitals. The software provides many benefits such as simpler accounting, security, collections tracking systems, medical billing management, creation of super bills, and numerous other tasks associated with Practice Management and Practice Workflow.
Problems Oklahoma Physicians Face :
Oklahoma physicians are dealing with numerous problems such as increased doctor-patient encounters and shortage of doctors, and these would worsen when the health care reforms come into full effect. This would mean that doctors would require experienced medical billing and coding specialists for denial management, ensure timely reimbursement, and compliance with HIPAA guidelines. Our billers at medicalbillersandcoders.com can ensure that these objectives are met in a timely and productive manner.
These billers would help you streamline your medical billing requirements in Oklahoma locally and their expertise in your specialty can optimize revenue easily.
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.