An Overview - Skilled Nursing Facility Medical Billing Services

Errors in documentation, denial of claims, and inadequate revenue are the major issues faced by the healthcare practices. Skilled Nursing Facilities are no different and they have to undergo various challenges in securing a sound financial posture.

The complexities in the SNF medical branch are the reason that stands tall between achieving a better bottom line. It is a concerning situation for many healthcare providers as medical billing brings a lot of pressure. A default in the process can not only cause revenue leakage but also hamper the mental health of the skilled nursing care providers.

Skilled nursing medical billing services aim to improve the situation of healthcare providers with required billing solutions. As a result, healthcare providers can redirect their focus on quality care and offer more satisfaction to their patients.

Let's dive into SNF medical billing and understand the various aspects that make this specialty challenging to handle. By the end of this blog, you will know the details and get your answer whether to outsource medical billing services.

Need for Skilled Nursing Facility Medical Billing Services

A skilled nursing facility is constantly occupied with patients having limited time for medical billing. The daily hassle is enough to keep the healthcare providers busy. However, neglecting administrative work is unfavorable for the healthcare facility as well.

The reason behind such negligence is the nature of a skilled nursing facility. If a patient is chronically ill or requires complete medical attention, they prefer a nursing facility. In many cases, patients need immediate medical care as well. Various services are offered in SNF, and they are:

Short-Term/ Immediate Care

This type of care is also referred to as skilled nursing aid. Usually, patients who need medical assistance with dressing, IV therapy, and injections are eligible for immediate care.

Long Term / Prolonged Care

Patients with chronic illnesses or disabilities come under long-term nursing care. This is because such cases require treatment for an extended time. Various patients may also require constant supervision. This is the function of LTC so that patients with prolonged health conditions can get medical care.

Rehabilitation

Recovery from a severe injury requires rehabilitation and SNF provides that to their patients. The treatment can be for complete or partial recovery. Skilled nursing facilities are known for providing prompt occupational therapy.

A skilled nursing facility is a hub of trained nursing professionals such as Certified nursing assistants (CNAs), licensed practical nurses (LPNs), and many other professionals.

The range of medical services that an SNF can offer their patients is the reason for the complexities in medical billing. The above-mentioned points highlight the importance of SNFs and clarify their role in providing the best care to patients.

For all the efforts that such healthcare providers make, there is a need for equal remuneration. This is vital from the facility’s point of view as well. For a healthcare facility to continue to offer extraordinary services, financial stability is vital as well.

Having said that, being financially sound depends on the efficiency of revenue cycle management and this needs skilled nursing medical billing services.

Challenges in Skilled Nursing Home Medical Billing

There is only one way to improve the revenue cycle and that is facing all the challenges of skilled nursing medical billing. Each challenge requires attention and once healthcare practices do that; they can achieve an efficient process.

However, healthcare providers constantly struggle with the time crunch, and medical billing is neglected. A comprehensive solution to all these intricacies is skilled nursing facility medical billing services.

Let’s find out all the challenges and how a medical billing company can help:

Incorrect Codes Result in Errors

The successful execution of a medical billing process is related to the usage of appropriate codes. Mistakes or errors in coding are the real reason behind denial of claims and revenue leakage.

To ensure the accuracy of codes, skilled nursing facilities must focus on keeping the codes according to the CPT codes. However, the reason it is challenging and prone to frequent mistakes is the multitude of codes for all the services under an SNF. The number of patients adds to this complexity making coding difficult and a task that hampers the revenue cycle.

Medical billing services realize the importance of correct CPT and ICD codes. They take all the appropriate measures to prevent errors and rectify them. As a result, the number of errors is reduced drastically leading to seamless revenue.

Failure to Keep patient Information Up to date

Different patients have different requirements, especially in the case of skilled nursing facilities. Some patients receive the service within the same day and others must stay at the facility. The changes in patient data must be updated on time. If the administration fails to do so, it creates a direct impact on the medical billing process.

As a result, keeping the information updated is the prime requirement for skilled nursing facility medical billing. A medical billing company follows every step to meet the ultimate goal of efficient and productive revenue cycle management. They ensure that each piece of information is recorded and updated on time.

Delays in Submission of Claims

Another challenge in medical billing is the need to submit the claims on time. In almost all cases, insurance companies decide on a due date for the submission of claims. If a healthcare provider or practice fails to meet this requirement, the consequences lead to revenue leakage.

Timely submission correlates with timely reimbursement and prevention of denials due to delays. It is essential to keep the chain of the medical billing process continuous by staying prompt.

Skilled nursing facility medical billing services are well-versed with the basic requirements of a medical billing process. It is their priority to perform every step on time. From filing the claims to their submission, everything is handled with precision.

Denials and Rejections

The reasons for denials and rejections are many. where some of them can be corrected others cannot. There is a procedure to reconcile some of the denied claims and recover the lost revenue. For other denials, the best course of action is to follow a proactive approach and prevent the risks beforehand.

In both cases, denials & rejections hamper the revenue cycle management, and they are a major challenge in improving administrative workflow.

When the denial is due to correctable mistakes, professional billing partners make the necessary changes and resubmit the claims. For other errors, the experts try to prevent the errors at the spot of their occurrence.

Regulatory Requirements

There are many regulatory requirements for skilled nursing facilities. Staying current with all of them is a cumbersome process and is a task for healthcare providers. There are compliance requirements such as HIPAA for the protection of sensitive patient information. It is vital to follow these rules to prevent the practice from legal outcomes.

Patient data is the most crucial among all other things. Skilled nursing facility medical billing services follow all the compliance requirements to ensure the safety of data.

Conclusion

Skilled nursing facility medical billing services prove to be the best choice for handling administrative tasks. A professional medical billing company helps healthcare providers face challenges with ease and makes the practice financially successful.

Eminence RCM is the medical billing company offering the best medical billing services in USA. We have a team of medical billing specialists who work to improve medical billing for skilled nursing facilities. Our services make sure to take away the administrative burden of healthcare providers.

Choose Eminence RCM for a better medical billing process that leads to revenue growth.