When you are running a skilled nursing facility, it is really important for you to ensure that you are not losing your hard-earned money as the SNF billing may sound easy but in reality, it is a challenging affair. Fortunately, you can still improve your financial side of the practice by hiring a professional Skilled nursing facility billing team.
When you do SNF billing, you need to send claims to health insurance companies so you can get the most money back for the care you give to your patients. A good SNF billing method makes sure you get paid properly by both your patients and their insurance. And remember, getting paid on time and accurately is super important for your practice to succeed.
Fortunately, you can ensure a perfect SNF billing solutions by following the tips mentioned below.
8 powerful steps for your skilled nursing facility billing services:
1) Register your patients properly:
You should always start with enrollment every time you see a patient, even if you’ve been treating them for a while. During your first meeting, gather the patient’s medical history and basic info for your records. Make sure you get important details like their address, phone number, and insurance info—especially for routine visits. Double-check things like their date of birth, insurance card, and address to make sure everything is correct.
2) Perform prompt insurance-verification:
You need to make sure the patient’s insurance info is up-to-date and correct when you enroll them. Also, check if any new visits need special billing, like for worker’s compensation or if there’s been an accident. Using a good skilled nursing facility billing system can make handling insurance way easier for you. At this point, double-check that the patient’s insurance is current, their info is right, and go over any out-of-pocket costs. Doing this now helps you avoid billing problems and delays later!
3) Assign accurate codes:
You or your coding team will figure out if a CPT or HCPCS code is the best one for the services you gave. Make sure you don’t bill bundled services separately, and pick the code that best matches what you did. You or your coders need to pick the right ICD-10 codes for the patient’s diagnosis.
4) Obtain prior auth approval:
You need to get prior authorization (PA) approvals from your patient’s insurance for some specific skilled nursing care procedures. Always make sure you get the PA approval before giving those treatments to your patients. If you don’t have the approval, you might get claims rejected or your patients might have unexpected out-of-pocket costs.
5) Enter your charges:
You and your team of skilled nursing facility billing services should create the medical claim using the visit codes. It’s super important to use the right codes because the wrong one can mess up the charges. Even codes that look similar can have different costs. Make sure you include all the costs with the right visit codes. A clear list of medical services helps you avoid mistakes and makes the process faster. If you make errors, the insurance might deny your claims or refuse to pay, and that could also lead to higher out-of-pocket costs for your patient.
6) Submit claims after review:
After you have double-checked everything for accuracy, you’ll need to file a claim for payment. You can usually do this electronically, and it goes through two steps: one to clean up the data and another to double-check everything. The software makes sure all the fields are filled out right and that the codes and charges match. Then, the claims get sent to a clearinghouse for a final check. They review important details like the name, insurance, and date of birth, and then they reformat the claim for each payer because not all of them use the same format.
7) Create statement for patient:
You need to prepare statements for the patient, making sure all the information is correct. If the total isn’t zero, explain the charges clearly and tell them what the insurance covers. This way, they’ll know what they owe. Also, include details on how to make payments, when payments are due, and how they can challenge any costs with their insurance.
8) Follow-up:
You finish the process by entering payments from both the patient and the insurer. Once the claims are approved, payments to the insurance companies happen automatically. Patients can also choose to pay for a procedure upfront or make a co-pay when they visit. Some patients might even decide to pay in advance when they’re younger.
You need to remember that getting paid for your services is what lets you make money, pay your staff, and keep things running smoothly. You might have to deal with collections, but you must handle all your cases on time before you start getting payments.
If you don’t have enough staff to handle your SNF billing services, you can outsource the whole process to a top billing company like Sunknowledge. The best part about outsourcing your skilled nursing facility billing is that it lets you focus on providing care, while your long term care facility billing partner takes care of the billing and helps boost your revenue by managing the whole process efficiently.
Comments