SNF Billing Services: 8 Critical Steps to Ensure Success

You know in skilled nursing facilities, billing and coding might seem simple, but they’re super important! You work hard, so you don’t want to waste your money on billing mistakes. When you have certified billers and coders, plus a smooth revenue cycle management process, you can really boost how well your finances do. It’s like having a pro team make sure your money is handled right, so you can focus on giving the best care.

In your SNF billing, you need to submit claims to health insurance companies so you get the most money back for the care you give your patients. A good skilled nursing facility billing process makes sure you get paid right by billing patients and insurance companies correctly. Always remember, getting paid on time and accurately is super important for your practice to do well. In your skilled nursing facility, billing really is one of the biggest keys to your success!

Fortunately, you can make your skilled nursing facility billing services robust by following the steps mentioned below.

8 Perfect steps to ensure an efficient SNF billing solution:

1) Systematic registration of a patient:

Every time you see a patient—even if you’ve seen them a bunch of times—you should start by checking them in. At the first visit, you’ll gather their medical history and basic details for your records. Make sure you have all the important stuff, like their address, phone number, and insurance info, especially for regular checkups. Double-checking things like their date of birth, insurance card, or address helps keep everything correct in their file.

2) Proper insurance-verification of your patients:

You need to make sure you’ve got the patient’s insurance info updated and correct when you check them in. And don’t forget to see if this visit needs special billing, like for worker’s comp or an accident. Having a solid skilled nursing facility billing system makes it so much easier for you to handle insurance stuff. Right now is when you confirm the patient’s insurance is current, double-check that all info is right, and look at any out-of-pocket costs. Doing this early helps you dodge billing headaches and delays down the road.

3) Collect up-to-date patient information:

When you’re with the patient, make sure you write down all the details you talk about. Take clear notes or, if you can, record the meeting with audio or video. After the visit, a medical coder will check out this info to add the right codes. It might even get transcribed later. You need to make sure the visit’s purpose is clear, include any diagnoses, and cover all the details. This helps your billing and coding team does their job right and gives the patient a complete medical history for the future.

4) Ensure accurate coding:

You and your coding team have to choose the right CPT or HCPCS code for the services you gave. Make sure you don’t bill bundled services separately and pick the code that best fits the work you did. You also need the right ICD-10 codes for the patient’s diagnosis. There are about 70,000 codes now, compared to just 13,000 in the old ICD-9—so way more options! This is why being detailed in your notes really matters. If you pick the wrong code, you could mess up the bill, cause delays, or even lead to denied claims, which hurts your hospital’s cash flow.

5) Obtain PA approvals for certain procedures, services and diagnoses:

Some skilled nursing care treatments need you to get prior authorization (PA) from your patient’s insurance company. You should always make sure you have PA approval before giving those specific treatments. If you skip this step, you might end up with claim rejections and surprise out-of-pocket costs for your patients. Getting that PA approval first helps you avoid these problems and keeps your patients happy!

6) Charge posting:

Now, your SNF billing solutions team will make the medical claim using the right visit codes. It’s super important to use the correct codes because using the wrong one can totally change the charges! Even if the codes look similar, they can mean different costs. Make sure all costs are listed with the right codes for each visit. A clear list of services helps you avoid mistakes and keeps things moving fast. If there’s an error, the insurance company might deny your claim or refuse to pay, which could also mean extra costs for the patient. So, double-check those codes!

7) Submit claims after careful review:

Once everything’s checked for accuracy, it’s time to file your claim. You can often do this electronically, and it usually goes through two steps: a data check and a final review. The software makes sure all fields are filled correctly and that codes and charges match up. Then, claims go to a clearinghouse for one last check. Here, they review key details (like name, insurance, and date of birth) and reformat the claim for each payer since formats can vary.

8) Create payment statement:

You need to prepare a clear statement for the patient once all info is correct. If they still owe something, show exactly what the charges are and what the insurance covers. This helps them see what they need to pay and why. Make sure to include how they can make payments, any deadlines, and steps for disputing costs with their insurance if needed.

You know that every step in the process is important, but getting paid for your services is what keeps your skilled nursing facility running smoothly. It’s how you pay your staff and cover all the daily costs. You might need to handle collections too, but make sure you meet skilled nursing facility billing services’ deadlines to start getting paid on time. If managing SNF services billing is a hassle or you don’t have enough staff, you can always outsource the entire process to a top long-term facility billing company like Sunknowledge. By outsourcing, you can focus more on patient care while your billing partner handles all the billing tasks, boosting your revenue and ensuring everything runs smoothly.