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.
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Now SNFs have to produce their claim as part of consolidated billing under the Prospective Payment System (PPS)
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SNFs are paid by Medicare A on a per diem basis
With more than 15 years of medical billing experience, our medical billers in all the major cities in Arizona like Phoenix, Tucson, Mesa, Glendale, Chandler have been providing expert medical billing and accounts receivable management over the years. They help in streamlining patient billing, collections and in the process of reimbursement for practices such as yours. The amount of effort put in by these billers guarantee:
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An increase in revenues
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Increase overall efficiency of your practice
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Helps in reduction of overheads
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Assurance of accountability of all billing procedures
Comprehensive Medical Billing Services in Arizona
Medical Billers and Coders (MBC) provides specialized medical billing services in Arizona, serving healthcare practices in major cities, including Phoenix, Tucson, Mesa, Glendale, and Chandler. Our skilled billers and coders bring over 25 years of experience and offer expertise in accurate data entry, coding, and payment review.
Our medical billing Services in Arizona ensure smooth operations and enhanced revenue cycles for healthcare providers. They focus on streamlining patient billing and collections and optimizing reimbursement processes.
Arizona's Leading Medical Billing and Coding Service Provider is tailored to align with state regulations, ensuring compliance and accountability in every billing process. Our experts guarantee:
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Accurate coding and detailed code audits
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Consistent insurance follow-ups
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Increased efficiency and reduced overheads
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Up to a 20% improvement in collections
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Higher profitability and steady growth for practices
By outsourcing Medical billing services to MBC, Arizona physicians can support federal efforts to reduce healthcare costs while maximizing their revenue potential.
Expertise and Comprehensive RCM Services in Arizona
Our MBC billers and coders specialize in:
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Eligibility verifications
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Electronic and paper claim submissions
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Payment and adjustment posting
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Claims denial management
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Accounts receivable recovery
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Patient statement services
Our experience with various billing software and certifications equips them to optimize operations and ensure HIPAA compliance, safeguarding patient information. For practices in Phoenix, Tucson, Mesa, Glendale, Chandler, and beyond, partnering with Medical Billers and Coders (MBC) ensures your clinic is on its path to growth, efficiency, and profitability.
For Healthcare providers in Arizona, our billers make your billing process seamless and trouble-free. Our services cater to all specialties and have billers who can work for you in or outside your office.
Our Medical billers specialize in servicing medical practices according to state regulations. They have acquired their knowledge and experience through years of effort in perfecting medical billing procedures, which they now leverage to help your practice collect more revenue.
Physicians in Arizona can only support the federal government's effort to reduce healthcare costs by optimizing costs and enhancing revenue. Let a Top Medical Billing Service Company handle your medical billing; it 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 these billers in Arizona 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
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Inaccuracy of codes applied leading to rejection of claims
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Insufficiency of knowledge of items covered by Medicare A and B
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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 the 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 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.
