The billing process for the service rendered to people who need constant medical monitoring and nursing care or recovery services for rehabilitation or perpetual care in case of sick, disabled persons is known as skilled nursing home billing. Such kind of billing process requires specialized skill sets. Only professional health personnel such as licensed practical nurses, registered nurses, and qualified technicians can handle such billing. Apart from these, few other specialist therapists who are also eligible for such a skilled Nursing Facility Billing Services process include physical therapists, occupational therapists, speech-language audiologists, or pathologists.
Keeping up with the ever-changing billing rules and regulations, Skilled Nursing Facility Billing proves to be one of the biggest challenges for the physicians demanding the need for outsourcing due to the following reasons:
Ensure Accurate and Timely Billing
Getting the claims rejected by the insurance companies or the lack of filing the claims appropriately is considered the kiss of death for a medical practice. It always indicates the situation of getting paid less. Such a mishap generally occurs when your current billing service is not paying attention to the task, or your existing billing staff lacks the required expertise to perform such medical billing in a timely and accurate manner without any errors.
In such a scenario, it is advisable to outsource the medical billing service to a company that has a proven track record of multi-tasking, such as claims preparation and submission, denial management, and A/R management with guaranteed results.
Low Rate of Denial Claims
One of the toughest problems a skilled nursing facility faces is filing clean claims with the insurance companies while navigating through their ever-changing billing requirements. Outsourcing the billing service is a great way to reduce the number of denied claims so that you can earn more revenues by getting paid quickly. The biggest advantage of hiring an expert billing company is that it can take away the burden of your practice billing to their shoulders by identifying the commonalities in the received denials types and correcting their root causes to accelerate your reimbursements. This demands fluency in all the coding guidelines and requirements of the insurance companies to ensure the accurate claims submission to be accepted the first time.
Improved Cash Flow
For medical practices, the old adage, “cash is king,” applies very aptly. Moreover, revenue cycle management is at the heart of the financial health of medical practice. The quickly your claims get paid, the healthier your business operates. If your accounts receivable (A/R) number is greater than 40 days, you must make an effort to improve the numbers. Any delay in the payment can directly impact the cash flows of your practice.
Minimizing the number of days in A/R and claim denials are two key secrets to maximize your practice revenue.
Thus, there is a need for submissions of clean claims and short payment cycles so that you can get reimbursed quickly. A recent A/R analysis based on some of the leading skilled nursing homes highlighted that:
- 14% of all the claims submitted to the insurance companies get denied and have to be either re-submitted or appealed or are written off by the insurance providers.
- 50% of the denied claims are never re-filed.
- 50-70% of the denied claims have a higher probability of getting recovered.
Thus, it is clear from the above findings that skilled nursing homes mainly suffer from account receivable skills and a lack of a proper denial management system. Medical billing can be a daunting task requiring skilled manpower with multi-tasking talent that most skilled nursing homes failed to have due to low-profit margin. Therefore, there is a higher need for outsourcing the medical billing process to professional 24/7 Medical Billing Services. Our experts believe in delivering cutting-edge skilled nursing facility Medicare billing services by working as a specialized operational extension. We work across numerous medical specialties such as orthopedics and prosthetics, dermatology, alcohol and substance abuse, and many more such medical facilities.