Billing Team Expertise

Our Medical Billing Team has over sixty-seven years of combined experience in Medicare, Medical Assistance, Medicare Advantage Plan, and Commercial Insurance Reimbursement for Skilled Nursing Facilities. We routinely deal with assisting various clients in meeting all of their reimbursement concerns. Our trained staff is ready to help you maximize your reimbursement within current industry standards. Our staff constantly monitors and informs our clients of regulatory changes and their potential impacts.

Are you concerned about?

  • Optimizing Reimbursement
  • Increasing Cash Flow
  • Reducing Outstanding Accounts Receivables
  • Billing Staff Experience or Knowledge
  • Increasing Efficiency
  • Reducing the Potential for Government Audits, stemming from claim errors and rejections
  • Preparing for Audits
  • Staff Turnover or Training Needs
  • Coverage Determination Issues

Medical Billing Services

  • Operational Reviews
  • Identification of Additional Reimbursement Opportunities
  • Billing and Clinical Audits
  • Accounts Receivable Reviews
  • Staff Training
  • Medicare Reimbursement
  • Medical Assistance Reimbursement
  • Medicare Advantage Plan Reimbursement
  • Commercial Insurance Reimbursement
  • Preparation for UMR and Medicare Reviews

UMR and Medicare Reviews

We offer various types of assistance in preparation for UMR and Medicare Reviews, including aiding clients with gathering documentation, offering advice regarding what types of deductions are allowable, and ensuring that claims reviewed by us are consistent with billing regulations and supporting documentation. These services offer our clients the opportunity to save money at the time of our review and also may assist in securing future revenues through staff education.

Operational Assessments and Billing & Clinical Audits

  • Operational assessments offer an objective review of processes that may lead to opportunities for additional revenue or expense reductions. It offers suggestions on how an organization may change to increase operating efficiency and may help to ensure longevity and success in our ever changing industry.
  • Billing and clinical audits focus on Medicare and Medical Assistance claims and related commercial insurance claims. We review all documentation supporting the claims to verify accuracy, identify staff training issues, and identify additional reimbursement opportunities, including claims correction, resubmission, or new areas for revenue opportunities.
  • Upon the completion of our Operational Assessments and Billing and Clinical Audits, a detailed report is provided with our findings and suggestions for correction and/or improvements.
  • These Services often pay for themselves in several ways:
  1. Identification of areas for expense reduction.
  2. Optimizing reimbursement from correction
    of billing errors, unbilled revenue, and
    identification of new revenue opportunities.
  3. Increased cash flow/reduction in accounts
    receivable outstanding.
  4. Increased staff efficiency and knowledge.

Reimbursement

Reimbursement is the cornerstone of every organization as it directly impacts cash flow. Lack of industry knowledge and reimbursement regulations often leave firms at a disadvantage in optimizing reimbursement and cash flow.

  • Billing and Clinical audits provide reviews of claims data to identify additional reimbursement opportunities, billing errors, and identify staff training issues.
  • We provide both short and long-term outsourcing of medical billing needs for: Medicare, Medical Assistance, Medicare Advantage Plan, and Commercial¬† Insurance billing.¬† We like to help our clients¬† realize every reimbursement dollar within industry standards.
  • Our HIPAA compliant software allows us to bill Medicare and Medical Assistance claims from our office. We are also efficient on many different nursing home billing software systems in order to complete billing from your location, or over the web via secure access.
  • We frequently provide on-site training to reimbursement staff to increase knowledge, reduce claim errors, reduce outstanding accounts receivables, and increase efficiency.
  • We provide accounts receivable reviews to determine the collectability of accounts, identify rebilling opportunities, and maximize cash flows.
  • We provide continued assistance to our clients by monitoring regulatory changes, researching coverage determination issues, and addressing continued billing concerns.