Legion Healthcare Solutions

Why Does a Skilled Nursing Facility Require a Medical Billing Service Expert?

Why Does a Skilled Nursing Facility Require a Medical Billing Service Expert?

Why Does a Skilled Nursing Facility Require a Medical Billing Service Expert?


In this article, we will try to comprehend how Medical Billing Service Experts can help talented and skilled nursing facility run their administrative affairs and revenue cycle in a much better manner. However, before we get into why a Skilled Nursing Facility requires a medical billing service expert, let us understand what a skilled nursing facility is in the first place:

What is a Skilled Nursing Facility?


A Skilled Nursing Facility is also called SNF. Whenever a person has a health-related crisis, then a skilled nursing facility comes to the rescue. This spot works as a temporary home for people who need clinical consideration. The clinical staff work day in and day out to support their patients and give them all the help they need to be in the best of health. The clinical staff offer support and service as long-lasting permanent specialists or they have been recruited on a legally binding premise like a contract. Many times, they are confused with nursing homes, which are poles apart. 


How Do Nursing Homes and Skilled Nursing Facilities Differ From One Another?


The immediate and principal contrast between the SNF and the nursing home is that:


At the nursing home, the inhabitants are for a permanent period of time. On the other hand, in the Skilled Nursing Facility, patients come for restoration and rehabilitation purposes and leave the facility in a brief timeframe. Usually, the skilled nursing facility releases the patients as soon as they recover. 


What are the Medicare Guidelines for SNF or Skilled Nursing Facilities?


The nurses that provide such services to the patients are of a secondary level and not so complex. It is important to note that these services play an important part in making sure that the patient is completely healed from the injury or ailment. However, a number of insurance companies like Medicare ignore these services.

 SNF Reimbursement System 


The other important aspect is that there are 2 types of coverage for SNF, or skilled nursing facilities. The first part is called Medicare A and the second part is called Medicare B.


The SNF Prospective Payment System (PPS) pays for all Part A amounts of inpatient services.

Important Aspects to Keep a Tab of: 


• In order to make sure Medicare pays you should make sure that that particular day is covered by Medicare


• Medicare does not allow ancillary charges for the days that are covered. However, they are included 

In the PPS rate.


Medicare Part B pays for the following services: 


Some services for patients that reside in a SNF but those whose benefit period is completed 


Outpatient services are covered for patients who are not inpatients of a SNF


Medicare B also consists of Services that are not a part of SNF PPS and SNF Billing in an integrated form. 


If a Skilled Nursing Facility wants to get the complete reimbursement of its claims, they have to submit all the information correctly. They should also be aware of the Medicare guidelines and codes. If the details are filled wrong, there is a chance of claim denial, and, in certain circumstances; it might lead to a penalty as well. Therefore, it is a good idea. To leave the work of medical billing in the hands of the experts. 

Why Should You Get in Touch with a Skilled Nursing Facility Billing Services Provider like Legion Healthcare Solutions?


Below Are The Main Reasons Why You Should Outsource Your Medical Billing Services To Legion Healthcare Solutions:

1. Responsible Team of Experts


Legion HealthCare Solutions has a good team of coders who are well-versed with the Medicare guidelines and other rules that apply to skilled nursing facilities and Skilled Nursing Billing. They are well aware of all the Skilled Nursing Facility Billing Revenue Codes and can work together with the facility to increase the revenue of the organization through timely payment of fees from patients and reimbursements from insurance companies. 


2. Complete the Entire Billing Service from Start to Finish 


Our Skilled Nursing Facility Billing Services team would be able to supervise the entire process of billing patients from start to finish. We would be able to check the status of claims, submit bills, and ensure that payments are received.


3. Provide a Detailed Report


We provide a detailed report to our clients. This report is in regards to your facility’s performance and how we are planning to improve the administrative and revenue parts of the facility. Moreover, we always try to find an opportunity to connect with our clients and discuss how the facility revenue cycle can be improved and made more efficient.


4. Denial and Delay Claim Management


We have in-depth knowledge of Skilled Nursing Facility Billing Codes. Not only that we make sure that we help the Skilled Nursing facility to follow up on denied delayed or rejected claims. Not only that they also give you regular reporting on such claims

5. Handle Appointment and Other Administrative Work 


There Are A Number Of Administrative Tasks Like:

1.    Booking appointments

2.    Check the eligibility and benefits of the patients.

3.    Help with refills of their meds. 


Legion Healthcare Solutions has expertise in them as well which will make the facilities work easier and help them concentrate on their core body of work.

6. Aware of All Aspects of Medicare Coding 


We are the Skilled Nursing Facility Billing Services Company of USA because we are completely familiar with Medicare coding. There are a number of patients that have Medicare insurance coverage. Therefore, in-depth knowledge about Medicare coding is inevitable to get reimbursements from Medicare.

Hope you liked the blog please get in touch with us in case of any medical billing assistance on   727-475-1834 or email Info@legionhealthcaresolutions.com