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
What makes our Virginia medical billers outstanding is their vast knowledge, level of expertise and their ability to incorporate innovative solutions which can streamline your billing process. They can help in enhancing the efficiency of your practice, increase cash flow and receive maximum reimbursements.
For many years our billers and coders have been providing medical billing services to practices in cities such as Virginia Beach, Norfolk, Chesapeake and Newport News. Some of the services which our billing professionals have been providing are:
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Accurate patient information filing
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Electronic Claims transmission
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Immediate posting of payments
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Aggressive follow up on aging receivables
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Resubmission of rejected claims
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Evaluation of reports on monthly earnings
Specialized Medical Billing Services in Virginia
Our specialized medical billing services in Virginia support healthcare providers across Virginia Beach, Norfolk, Chesapeake, and Newport News. We deliver comprehensive RCM solutions, including precise patient information management, electronic claims processing, and strategic payment oversight.
Understanding Virginia's distinct healthcare insurance laws and consumer protection regulations, our team maintains current knowledge of state requirements while ensuring compliance with federal regulations. Through innovative approaches to revenue cycle management, we help practices optimize reimbursement rates while streamlining operational efficiency.
Virginia Medical Billing Specialists Drive Practice Growth
Virginia's Medical billing specialists combine local market knowledge with advanced coding expertise to enhance practice performance. Through efficient claims processing, aggressive accounts receivable management, and strategic fee schedule analysis, we help practices improve collections by 20%.
Our certified medical billing and coding team brings over 25 years of extensive experience in health records, medical terminology, and advanced coding strategies to optimize revenue cycles. By leveraging a comprehensive understanding of regional reimbursement rates and state regulations, a Top medical Billing Company, MBC, helps Virginia medical practices achieve sustainable growth while meeting federal cost-reduction initiatives.
This holistic approach enables healthcare providers to maintain strong financial health and growth while ensuring regulatory compliance.
Virginia has several laws that provide fairness in health insurance and protect its consumers. Your Billing staff must be well-informed about changing regulations to help your clinic follow all federal guidelines. Our billers in Virginia are trained in coding Health Records, Medical Terminology, and Advanced Coding and Reimbursement strategies.
These Virginia Billers can also compare fee schedules for your practice as they have extensive local exposure and know the best prevailing reimbursement rates.
Our Billers in Virginia 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.
The federal government’s effort to reduce healthcare costs can only be supported by physicians in Virginia by optimizing costs and enhancing revenue. Let a Leading Medical Billing Service Provider 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 receivable, are the basis on which these billers in Virginia 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.
