Optimize Your SNF Reimbursement with Specialized Medical Billing
Providing high-quality care to your rehabilitation and long-term residents depends on receiving proper payment for services delivered. But nursing facilities often leave revenue on the table due to outdated billing practices and undercoded claims.
Medwave partners with SNFs nationwide to maximize reimbursement through compliant, optimized billing capture.
Our specialized services include:
- Comprehensive audits examining documentation and coding to pinpoint revenue gaps
- Ongoing training for nursing and therapy staff on proper billing protocols
- Having a good understanding of which CPT codes are used in nursing facility billing
- Scrubbing of EMR clinical records to ensure codes accurately reflect services provided
- Management of billing edits and denials through automated appeals and escalation protocols
- Custom reporting quantifying financial performance improvement opportunities
- Staying atop changing payer policies to ensure continued compliance
- Patient liability estimates and upfront collections counseling to minimize unpaid claims
Our SNF billing experts become an extension of your team to ensure every provided service gets coded and claimed accurately at the highest justifiable rate. We leverage the latest rules-based automation to optimize efficiency while our RN auditors provide clinical validity.
The result? Healthier cash flow through:
- 12% average increase in per-claim reimbursement
- 47% higher claims acceptance rates
- 35% faster claim turnaround times
- 81% denial overturn rate through optimized appeals
Patient Billing Support
We recognize billing processes don’t end once insurance claims go out. Patient billing and collections require equal expertise to avoid revenue loss.
Our teams provide:
- Customized patient statements clearly conveying balances and payment options
- Expanded self-service portals enabling affordable budget-friendly payment plans
- Proactive follow up and balance chasing to bring accounts to resolution
- Financial assistance application completion ensuring patients meet obligations within constraints
- Total balance visibility and cash posting reconciliation even across multiple facilities
Compassionate counselors educated on SNF care nuances assist your patients 1-on-1 as we serve as an extension of your organization. We aim to remove financial friction from their care journey.
Specialized Staff for Complex Billing Protocols
Rehab, infusion therapy, enteral nutrition and other services require adherence to highly specific payer billing policies beyond routine codes. Our seasoned nursing home billing experts have mastery of these protocols earned from years focused solely on SNF reimbursement. No other receivable is too intricate for our team to tackle optimally on your behalf.
Multi-Facility Management
Larger regional and national SNF providers require consistent billing expertise across all their locations and markets. We assign designated teams to each individual facility to ensure customized workflows, while clinical leadership oversees best practice consistency across the enterprise. This enables scalable growth without variability.
Eligibility Verification and Insurance Expertise
One of the first areas of revenue leakage for SNFs stems from gaps in insurance eligibility and benefit verification prior to admission. Our teams complete real-time coverage checks to validate active status, network participation, prerequisite prior authorizations and more. We then estimate accurate liability amounts and personalized payment plans to set proper financial expectations with residents. This prevents unpaid claims exposure before services render.
Ongoing Payer Policy Monitoring
Rules and requirements fluctuate constantly across Medicaid, Medicare, and private insurers. Our dedicated resources stay abreast of changes to ensure your billing protocols align. We also offer real-time payer policy databases for your staff to reference. This prevents claim rejections and underpayments due to outdated practices. Our insights span major payers to eliminate denial root causes.
Claims Submission Automation and Tracking
Manual claim generation ties up your billing staff and inevitably leads to submission errors triggering denials. Our platform automates creation and delivery of complete, compliant claims to all associated payers at once. Rules-based algorithms verify accuracy pre-submission while real-time status dashboards ease follow-up. Automation accelerates cash flow with more claims going out faster, clean the first time.
Analytics and Reporting for Continual Improvement
We arm SNF leadership with visual dashboards and drill-down reporting quantifying billing metrics. Key analyses cover denial causes, collection cycles, revenue capture by RUG categories, and overall billing performance against benchmarks. Our data insights uncover optimization opportunities to drive continual improvement in SNF reimbursement and financial outcomes.
Don’t leave revenue on the table. Contact Medwave to discuss how our skilled nursing facility billing services can strengthen your financial performance. Don’t let billing challenges obstruct your facility’s goals. Leverage our expertise and technology.
