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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

MBC, a medical billing company based in Texas, brings 20+ years of experience and best practices to the table. We make your revenue cycle management more cost-effective, efficient and profitable. Outsource your billing process and not the control of your processes. Physicians always search for what is the average charge for medical billing services in Texas market but we offer customized billing services plans that can be affordable to small to large scale physicians group.

Benefits of medical billing services

Error-free billing process

Our staff is experienced and well trained and have extensive knowledge of complex claim submission processes. MedicalBillersandCoders staff undergoes rigorous process training and complete the required quality and domain-driven knowledge assessment.

Accelerates Cash Flow

MBC’s outsourcing billing services allow clients to maintain a consistent cash flow and fast collection. Physicians can achieve greater economies of scale by letting us do the medical billing quickly.

Improves Patient Satisfaction

Physicians can afford to exclusively focus on patient care. MBC’s main focus lies in maximizing the client’s revenue. Outsourced medical billing services make sure that each code gets correct reimbursement quickly, errors are identified swiftly, and denials are followed up rapidly.

Billing Compliance

We are HIPAA compliant medical billing company. We ensure that compliance is deeply integrated into all operations.

Our Medical Billing Services in Texas

The law states that the payer has to pay a clean claim within 30 days, with the option of 45 days if the claim is not submitted electronically, thus our Texas billers will be able to reduce your AR days noticeably.

Our professional billers in Texas are trained to handle all aspects of Revenue Cycle Management which especially includes denial Management and helps you recover rejected claims by appeals and resubmission of claims.

Our Billers in the state of Texas 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 Texas 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 these billers in Texas 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.

Texas Medical Billing Services provides:

  • Data entry of all charges
  • Submission of electronic as well as paper claims to both primary and secondary insurers
  • Accurate ICD-10 and CPT code audits
  • Payment postings after receiving from insurance companies as well as patients
  • Excessively customized Monthly financial reports
  • Comparing payer fee schedules and updating your practice about it
  • Medical billing consulting services

MBC’s staff has extensive Medical Billing knowledge and 15+ years of experience. We can help providers and practices in and around Texas to maximize their reimbursements and minimize their costs.

Take a look at Pros and Cons of Various Payment Models and their Effect on Practices

Still, looking for medical billing companies in Texas?

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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 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.

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