A lot of people in the US still confuse Skilled Nursing Facilities with conventional Nursing Homes. A Skilled Nursing Facility, or SNF, is populated by occupational therapists, speech-language pathologists, physical therapists, licensed practical nurses, and of course, certified nurses.
Unfortunately, billing operations in SNFs have always been confusing and frequently result in a high number of denials.
In 1997, as part of the Balanced Budget Act, Congress required that a significant portion of services within Skilled Nursing Facilities be encompassed in a potential bundled payment managed by a Part A Medicare Administrative Contractor (MAC).
Challenges with Accounts Receivable for Skilled Nursing Facility Practices
Most medium and small-sized SNFs find account receivable services something like climbing a steep hill. One of the critical reasons is budget constraints as most practices do not have adequate financial muscle to establish a dedicated team for handling A/R and denials. Even if practices manage to establish a dedicated skilled nursing facility accounts receivable services team, they often find it challenging to locate experienced and skilled resources with in-depth knowledge of handling aged A/R buckets and complex denial management cases. This is exactly where old hands matter the most!
If you are running a Skilled Nursing Facility, you can only provide the best care to your patients when your administrative priorities have been taken care of in the right manner. However, it is not a difficult goal. You can dodge the pain of investing money, effort, time, and other resources in building a team from scratch by outsourcing SNF Accounts Receivable Management to a dedicated specialist.
Research reveals that approximately 41% of adults in the United States carry healthcare debts, with at least $500 owed to their providers by each on an average. A facility must ensure that it receives the maximum reimbursement from Payers and patients alike. This is exactly where professional skilled nursing facility accounts receivable play a vital role.
Outsource Skilled Nursing Facility Accounts Receivable Services
It is a well-known fact that a better invoicing process leads to a better revenue flow. Our cutting-edge A/R services enable you to streamline your collection process by adopting the industry-best invoicing processes for your practice. Our services ensure the creation of accurate invoices, timely A/R follow-ups on current and aging accounts receivables, and resolution of outstanding claims in the most satisfactory way. With Suknowledge, you can enjoy uninterrupted cash flow from aged accounts that you might have already given up on. Unlike many competitors, our specialization lies in managing A/R aging buckets exceeding 90 days, ensuring maximum returns for your practice.
Within Skilled Nursing Facilities, a prevalent issue involves high denial rates due to billing staff oversights. Our skilled nursing facility accounts receivable help mitigate nearly 90% of these denials, allowing for smoother operations.
A Closer Look at Our Skill Nursing Facility Accounts Receivable Services
Our skilled nursing facility accounts receivable services follow-up strongly focus on increasing collection for our clients. This particular process starts after the provider creates and sends Health Insurance Claims (Electronic/Paper claims or manual HDFA forms) to various payers.
Our follow-up pattern depends on the transmission type and length of time since submission. Online claim follow-ups involve checking the status of outstanding claims through insurance company websites and online Payer portals. Automated claims follow-ups, via Interactive Voice Response (IVR) systems, entail calling insurance companies to obtain the status of unpaid claims. In cases where information is not accessible through these methods, contacting a live insurance company representative provides more detailed reasons for claim denials.
Skill Nursing Facility Denial Management Services
There can be several reasons behind a claim denial. We provide end-to-end assistance that analyzes the causes of denials. Some of the frequent causes that we often encounter from our skilled nursing facility accounts receivable services are-
- Authorization challenges
- Referral discrepancies
- Requests for medical necessity and medical records
- Out-of-network insurance concerns
- Invalid insurance details
- Coordination of benefits errors
- Diagnosis inaccuracies
- Comprehensive procedure considerations
- Partial payment issues
- Out-of-network claim verification and deductible matters
- Electronic Data Interchange (EDI) rejections
- Lack of claim status and absence of filed claims
- Personal Injury Protection (PIP) cases
How We Streamline Your SNF Accounts Receivable Collections
- Claim correction and resubmission: These claims are corrected, modified, and resubmitted as corrected claims to avoid billing patients.
- Patients’ responsibility: The claims cannot be further processed and the patient is responsible for paying the final amount. Usually, patients’ bills include in-network deductibles and non-covered benefits as per their insurance plans. We provide a detailed statement to the patient with a clear explanation of the balance due.
Benefits of Accounts Receivable for Skilled Nursing Facilities
- Achieve at least 30% reduction in A/R within 30 days
- Expertise in tackling challenging, aging A/R cases
- Each of our A/R specialists brings a minimum of 3 years’ experience
- Over 7 years of adept claim adjudication experience in the US
- Up to 80% reduction in your current collection cost
- Guarantee of 99.9% accuracy and a 97% first-pass rate for claims filed by us
- Recovery of A/R from 30+ day-old buckets
- Full compliance with HIPAA regulations
- No binding contracts; exit anytime
- Tailored reporting options (Daily/Weekly/Monthly)
- Dedicated Account Managers at no extra cost
- Adherence to the highest productivity standards
- Extensive list of top-notch references to vouch for our services
Start your journey to enjoy maximized collections from accounts receivable with Sunknowledge. Build a strong wall against revenue leakage and completely transform your Revenue Cycle Management with one of the nation’s best skilled nursing facility accounts receivable companies.
Schedule a no-obligation call today before decide to outsource SNF accounts receivable services.