November 20, 2015
One of the biggest challenges faced by nursing centers is to achieve high quality care while making a good profit. Improving the revenue flow of such centers can be problematic because most of the strategies for increasing profitability consume time and resources and have uncertain payoffs. Nursing facilities also struggle to meet federal quality standards. Due to lack of resources, these centers are not able to optimize their total reimbursement or improve their operational efficiencies.
• Many nursing homes across the US have faced issues of bankruptcy due to increasing loss of revenue
• Majority of payment for services received by nursing homes is through Medicaid; however, with fluctuations in Medicaid payments without much notice, nursing facilities have been experiencing cash flow disruptions.
What are the Challenges Plaguing Nursing Facilities?
Nursing centers, having more than 90% of its residents funded by Medicaid also face revenue challenges due to low Medicaid rates. It can be difficult to cover the costs if the center lacks experienced staff or if there are inefficiencies in the workflow.
Most nursing facilities are certified for providing services to individuals who are eligible for Medicare as well as Medicaid. This makes medical billing complicated as claims have to be submitted for Medicaid, Medicare and several other insurance providers. If the billing staff is not efficient, nursing homes will not be able to receive revenue for rendered services.
Due to the advent of ALFs (assisted living facilities), many individuals who would have once been admitted to nursing homes are now placed within ALF environments. This has cut into the financial backbone of this industry, resulting in low occupancy rate and less money for ensuring quality care to the older and sicker patients.
How to Improve Revenue Flow?
There are basically two ways of improving the revenue flow of nursing centers- reduce costs or find ways to increase revenue/prices while keeping costs at bay. Since the market is already competitive, increasing prices can be problematic, especially when the market has been exerting downward pressure on how much healthcare providers can charge for rendering services.
In order to cut costs, nursing centers need to get rid of inefficiencies in the billing process or workflow that can be eliminated or reduced. They need to review their operations periodically so that they can become more efficient.
Nursing Centers Benefitting from Outsourced Medical Billing
Growing number of nursing centers across the US are outsourcing their billing and coding needs to a third party like MedicalBillersandCoders.com. This has helped them eliminate cash flow disruptions caused due to coding inaccuracies. It has also given them the required time to focus on workflow inefficiencies that are costing them money.
MBC’s skilled billers and coders help nursing centers minimize medical claim rejections. They have extensive knowledge of nursing center billing requirements. They are well-trained in identifying patient eligibility for reimbursement, separating items covered under Medicare A and Medicare B and helping providers comply with reforms and other requirements.
Best Billing and Coding Practices