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Skilled Nursing Facility Billing Services Vermont, VT

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

Your practice can suffer with changing healthcare conditions and reductions in reimbursements can prevent you from retaining quality staff. At the same time maintaining the level of profitability for your practice can be quite a challenge.

Our Vermont medical billing professionals, with their exceptional expertise in billing and collections services can help you to streamline your daily operations as well as increase your practices’ expansion and find more time to deliver your patients with the highest degree of care. These Billers are present in almost all major cities of Vermont like Burlington, Essex, Rutland, Colchester, and South Burlington.

Our Billers are specialized in providing the following Medical Billing functions:

  • Data entry of patient demographic
  • Analysis of accounts receivables
  • Aggressive follow ups on transmitted claims
  • Tailor made practice management reporting
  • Speedy eligibility verification

Dealing with a variety of payers in Vermont while you concentrate on Patient care can be just one of those various advantages your practice can derive from these billing professionals. These Billers are also motivated to keep their certifications updated so as to help your clinic collect better revenue on the basis of their knowledge.

Training and maintaining administrative staff was never easy and in a situation where you loose them often, you must know a good place to get the best resource, fortunately we currently have a many experienced billers and coders in Vermont.

Our Billers in the state of Vermont 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 Vermont 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 Vermont 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.