Medicare Nursing Home Billing: How it Works?
Medicare nursing home billing with its complexity and uncertainty is a specialized area and the professional billing services are the best ones to handle it.
[USPRwire, Sat Apr 14 2018] Medicare nursing home billing has a typical complexity around it. For patients paying from out-of-pocket, nursing home care is quite a burden for them owing to the expensive nature of the treatment. Even people having Medicare coverage are not in a very comfortable situation with their nursing home bills as Medicare doesn’t cover long-term care nursing homes stays in many cases. However, Medicare covers expenses for hospital care, doctor visit fees, medical supplies, etc. during the patient’s nursing home stay, reducing the burden to an extent. Due to this typicality, nursing facility Medicare billing issues are rampant in the nursing homes across the country. However, leading Medicare nursing home billing services like Sunknowledge Services Inc., with their experience and expertise help salvage the situation for them.
Medicare Nursing Home Billing: The SNF Reimbursement
Medical billing and coding for skilled nursing facilities (SNFs) also involve a bit of complication. Continuous regulatory changes and restrictions affect the reimbursement for services received in an SNF. Reduction in potential fraud and abuse often caused by double billing by healthcare providers was a concern and to combat it, the Prospective Payment System (PPS) was introduced for SNFs to bill Medicare. A consolidated billing system has been implemented, wherein the services provided to a Medicare beneficiary need to be together and billed under the PPS as one consolidated healthcare claim.
Usual services billed by an SNF include:
• Medical tests
• Transportation-related to routine medical appointments
• Physician’s care
Why Do You Need a Professional Medicare Nursing Home Biller?
Determining the codes that will qualify for consolidated billing needs professional expertise. Only trained medical billers are the best entities to use the appropriate codes. Professional nursing home billing services have trained, formally educated, and experienced billers and coders in their ranks who handle the job with the skill that the providers’ in-house staffs cannot afford. These services take care of several aspects of nursing home care billing like Accounts Receivable through AR analysis, follow-ups, and claim closures. They also oversee the entire denial management system maintaining proper mechanisms. Trusted names in Medicare nursing home billing like Sunknowledge take it a bit further by offering a complete Revenue Cycle Management and/or Practice Management solutions.
Director of Business Development at Sunknowledge
Phone: +1 646-661-7853
Fax: +1 212-924-3473