Nursing Home Billing Services

Specialty Focus

Nursing Home Billing That Captures What You've Earned

Long-term care and SNF billing operates under a different rulebook than outpatient medicine — PDPM calculations, Medicare Part A/B distinctions, MDS assessments, and consolidated billing requirements create complexity that demands dedicated specialisation.

Our long-term care billing team manages Medicare Part A SNF consolidated billing, PDPM resource utilisation group calculations, MDS coordination, and Medicaid waiver billing. We ensure your nursing facility captures the maximum allowable reimbursement on every resident stay.

97%

First-Pass Clean Claim Rate

24h

Average Claim Submission

40%

Average A/R Reduction

Medicare Part A/B SNF billing

PDPM calculation & tracking

MDS assessment support

Consolidated billing compliance

Medicaid waiver billing

Therapy service billing coordination

Ancillary service claims

Monthly AR & census reporting

Electronic remittance posting

Monthly performance reporting

Specialty-Trained Coders

Our billers are trained in your specialty's CPT codes, ICD-10 diagnoses, and payer-specific rules — not generalists working across 50 specialties.

97%+ Clean Claim Rate

We scrub and submit clean claims the first time, reducing rework, accelerating payment, and improving your net collection rate.

24-Hour Denial Recovery

Every denied claim is reviewed within 24 hours, root cause identified, corrected, and re-submitted before payer appeal deadlines close.

Full HIPAA Compliance

Encrypted data handling, a signed Business Associate Agreement, and annual compliance audits — your patients' information is always protected.

Maximize Your Nursing Home Revenue

Get a free billing audit and find out exactly how much revenue your practice could be recovering. No contracts, no obligation — just results.

Get Your Free Billing Audit Call 346-307-9057

HIPAA Compliant • No Long-Term Contracts • Results in 30 Days

Do you handle both Medicare Part A and Part B nursing home billing?

Yes. Part A SNF billing (UB-04 claims for covered skilled stays) and Part B billing (CMS-1500 for physician visits 99304–99318, therapy, and ancillaries) require entirely different billing workflows. We manage both simultaneously, coordinate with MDS staff for accurate billing period data, and track benefit days to prevent billing outside covered windows.

How do you handle SNF billing under the Patient-Driven Payment Model (PDPM)?

PDPM replaced RUGs in 2019 and now drives SNF reimbursement through patient characteristics rather than therapy minutes. We work with your MDS coordinators to ensure accurate ICD-10 coding on the MDS drives the correct PDPM classification — directly impacting your per diem rate for each clinical category.

How do you manage skilled nursing facility consolidated billing rules?

SNF consolidated billing requires that most Part B services during a covered Part A stay be billed by the SNF, not the individual provider. We identify the covered stay period for every admission, flag services subject to consolidated billing, and prevent double-billing errors that trigger costly audits.

What is your process for managing long-term care E&M billing for physicians?

Long-term care visits (99304–99318) are billed by the attending physician or NP/PA under the facility modifier. We ensure the correct visit level is supported by documentation, manage incident-to billing rules for mid-levels, and track monthly visit frequency to ensure compliance with Medicare requirements.

Nursing Home Billing That Captures What You've Earned

Key Billing Areas for Nursing Home Practices

Built for Nursing Home Billing Complexity

Specialty-Trained Coders

97%+ Clean Claim Rate

24-Hour Denial Recovery

Full HIPAA Compliance

Maximize Your Nursing Home Revenue

Nursing Home Billing — FAQ

We Serve All Medical Specialties