After working with numerous skilled nursing facilities, we understand the depth of care you provide to residents in their most vulnerable moments. Your 24/7 dedication to patient care demands billing support that’s just as attentive, accurate, and relentless. That’s precisely what our nursing home billing services in the USA bring to you. We cover all essential aspects of SNF revenue cycle management, including:
We let you run your nursing facility with financial freedom and peace of mind.
Nursing home billing involves navigating complex PDPM coding, managing ever-changing Medicare & Medicaid eligibility requirements, and handling intricate SNF billing workflows. It often feels overwhelming when you have to juggle between patients and administrative tasks.
Our PDPM billing solutions are truly a breath of relief for your practice. We carefully follow SNF consolidated billing rules, incorporate CMS’s daily rate requirements, and ensure that every billable service is correctly submitted to payers (leaving no chance of losing revenue).
Our goal is to optimize payments and help you avoid denials, penalties, and unnecessary stress that comes with it. We save you from bad debt! And carefully bill services covered under Medicare Part A or B.
Inaccurate or outdated ICD-10 coding
Duplicate claims (Medicare Part A services incorrectly billed under Part B)
Incomplete or insufficient clinical documentation
Authorization errors (missing or unverified insurance eligibility)
Non-compliance with payer or CMS billing guidelines
Lack of documented medical necessity or missing medical records
Late or improperly submitted claims
EDI (Electronic Data Interchange) formatting or submission errors
Unverified or ineligible PIP (Personal Injury Protection) insurance coverage
Incorrect Use of Revenue or Condition Codes
Billing for Non-Covered Services
Failure to Submit Timely NOA (Notice of Admission)
Eligibility lapse
Nursing homes often face underpayment issues due to the per diem rate for nursing homes. However, our MDS and billing experts ensure your facility is placed in the correct case-mix groups to maximize per-patient reimbursement.
We include medical necessity in your claims when needed to help you get paid for additional services and avoid denials. Our nursing home billing services are fully compliant with HIPAA regulations and current CMS rules as of 2025.
We also identify the loopholes in your existing billing workflows and resubmit denied claims to payers to protect your practice from revenue leakage. To maintain high clean claims rates, we continuously process your claims through our AI scrubbers to detect early coding errors before final submissions.
Choose the best for your long-term care facilities by trusting us because we care like no other nursing home billing company does!
We have been leading the way in skilled nursing facility billing services for decades, as our experienced experts know the key to achieving high numbers for your practice. We utilize industry best practices to ensure your claims get reimbursed successfully, without getting stuck in the pipeline of delays and rejection.
Take our numbers for it:
20%
Improve collections
40%
Improve collections
98.5%
clean pass rate
1.2%
300+
AAPC/AHIMA/CPC-certified coders
100%
PEPPER outlier audit for SNF
AI denial prediction for nursing home claims
A/R over 90-day cleanup strategy
No Surprises Act price estimator for post-acute care
Timely iQIES submission
Transparent room-&-board rates
Offer text-to-pay
Guardianship billing workflows
KPIs Dashboard
Automated prior authorization management
RPA bots for 276/277 status
Charges submitted within 48 hours
RCM management
| Codes | Purpose |
|---|---|
| Rehabilitation Services |
97110: Therapeutic exercises to develop strength 97110: Therapeutic activities to improve functional performance. |
| Mental Health Services |
97110: Psychotherapy, 30-minute session 97110: Emotional or behavioral assessment |
| Palliative and Hospice Care |
97110: Physician management of hospice patient care. 97110: Physician management for higher-complexity hospice care. |
| General Medical Care |
97110: Primary nursing facility care, 97110: Subsequent nursing facility care |
Discover how physician groups thrive with us.
Long-term-care RCM outsourcing brings in dedicated experts who stay updated on CMS policy changes, prevent billing errors, and reduce claim rejections. It allows your staff to focus on patient care while we handle compliance, charge entry, A/R follow-ups, and ensure audit-ready reporting for your skilled nursing facility.
