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Nursing Home Billing Services
Maximize Reimbursements & Reduce Denials in the USA

A2Z Medical Billing Services helps nursing homes and skilled nursing facilities streamline billing, reduce denials, and optimize cash flow across the USA.

About A2Z Nursing Home Billing Experts

We are a New York–based medical billing company serving more than 4000 nursing homes nationwide. Our certified medical billers and coders are trained in HIPAA best practices, helping nursing homes stay compliant while improving revenue recovery. Our nursing home billing services are based on 10+ years of expertise in post-acute and long-term care billing.  

Outsourcing skilled nursing facility billing services is the most viable and beneficial option for healthcare providers and long-term care facilities for the maximization of revenue. Our RCM team’s in-depth knowledge and expertise lowers the claim denials and revenue leakage, offering peace of mind and freeing you from revenue cycle headaches.

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Challenges in Nursing Home Billing

Complex Payer Mix

Varying policies, regulations, metrics, medical coding, and billing processes regarding reimbursements between different insurers like Medicare, Medicaid, private pay, and commercial companies present a unique challenge for nursing homes and medical professionals.

Frequent Claim Denials

Missing, incorrect, and outdated ICD-10, CPT/HCPCS codes become a major source of claim denials, damaging cash flow. Healthcare facilities suffer from underpayments, regulatory non-compliance fines due to consistent denials.

High Staff Turnover

A higher number of trained and skilled staff leaving nursing home agencies disrupts efficient revenue cycle management. This high turnover also results in slow claim generation and late submissions.

Changing CMS Regulations

Ever-changing regulations of Medicaid and Medicare damage the revenue collections of nursing home practices by introducing new risks and complexities. Additionally, training in-house staff on these changes takes time and significant resources.

Managing Long-term Care Authorizations

Managing time-consuming approval processes from private insurers, Medicare, and Medicaid on behalf of skilled nursing facilities and senior care providers is a big challenge if your patient requires immediate medical care or intervention.

Our Billing Solutions for Nursing Homes

A2Z nursing home revenue cycle management services help home health agencies by offering the following solutions:

Medicare & Medicaid Billing for Nursing Homes

Our nursing home billing services offer accurate medical billing for Medicare and Medicaid insurance plans, improving quality care. Our team’s consolidated billing and timely claim submissions increase billing operations efficiency.

Skilled Nursing Facility (SNF) Claims Processing

Our skilled nursing facility billing services USA serve as the backbone for practices offering medical care and rehabilitation services to patients. As a professional medical billing company, we streamline your billing procedures.

CPT/HCPCS Coding Accuracy for Long-term Care

Our AHIMA and AAPC-certified coders add updated HCPCS codes for long-term care, CPT codes, and nursing ICD-10 codes for accurate coding and diagnosis. Our approved billing practices reduce revenue leakage and increase high-quality care.

Provider Credentialing & Payer Enrollment

Our outsourced nursing home billing company also manages nursing facility credentialing and payer enrollment with various insurance companies to reduce liability risks and improve financial health via in-network and out-of-network enrollment plans.

Eligibility & Benefits Verification

With the help of our SNF Billing Services USA, practices may perform prompt prior authorization and insurance eligibility checks for better claims processing. We use advanced technology for the insurance verification process to reduce billing errors.

Denial Management & Appeals

We offer denial management for nursing facilities that comply with the latest billing regulations. Accurate coding and billing expertise of our team helps you file appeals on these denials to insurance companies and recover reimbursements.

Revenue Cycle Management (RCM) Optimization

Our nursing home revenue cycle management services help create faster and accurate claims processing. Accurate coding based on updated ICD-10 codes maintains health records and billing procedures for nursing home care practices.

Patient Statement Management

AR’s outsourced nursing home billing solutions comprise the industry’s best billing practices for improved practice management outcomes. Our skilled nursing home medical billing experts provide accurate patient statements for optimum transparency between the provider and patients.

Compliance with CMS Guidelines and PDPM

Our PDPM billing solutions help providers in meeting the billing requirements of different insurance companies. We completely handle Medicare and Medicaid billing for nursing homes and get practices reimbursed through prospective payment systems.

CPT & HCPCS Codes for Nursing Home Billing

CPT Codes

99304–99310 → Nursing Facility Evaluation & Management (E/M) codes

99315–99316 → Discharge Services

99318 → Annual Assessment

99324–99328, 99334–99337 → Domiciliary/Rest Home services

HCPCS Codes

G0378 → Hospital Observation

Q5001–Q5010 → Place of service for home & facility care

A0428, A0429 → Ambulance services (often linked with SNF billing)

ICD-10 Codes in Skilled Nursing Facilities (SNFs)

M62.81 – Muscle weakness (generalized)

99315–99316 → Discharge Services

R26.2 – Difficulty in walking

I50.20 to I50.43 – Various types of congestive heart failure

G30.0 to G30.9 – Alzheimer’s disease (early/late onset, unspecified)

J44.9 – Chronic obstructive pulmonary disease (COPD)

F03.90 – Unspecified dementia without behavioral disturbance

N39.0 – Urinary tract infection, site not specified

R13.12 – Dysphagia, oropharyngeal phase

M15.0 – Osteoarthrosis, generalized, multiple sites

Industries We Serve

We offer nursing home billing services to a variety of healthcare providers to optimize their billing practices. Our billing staff performs timely eligibility verification steps, adds billing codes, and submits electronic claim for skilled nursing care facilities. Our nursing home medical billing is suitable for:

Nursing Homes
Home Health Agencies
Hospices
Primary Care & Specialty Clinics

Why Choose A2Z Billing Services for Nursing Home Billing?

Based in New York, serving all 50 states.
Experienced in handling complex SNF billing and long-term care reimbursement.
Dedicated account managers with 24/7 support.
Proven track record of reducing denials by up to 30%
End-to-end RCM solutions tailored to nursing homes.
10+ years of experience in serving nursing home practices
Award-winning SNF claims processing services
Payer-specific billing procedures ensuring better compliance
Rapid accounts receivable recovery past 120 days
Coding services based on updated CPT codes and billing practices

Partner with A2Z Billing Services and Ensure Your Nursing Home Never Leaves Money on the Table

Frequently Asked Questions(FAQs)

What is the difference between nursing home billing and home health billing?

The difference between nursing home billing services and home health billing is simple, but understanding the nuances of these two distinct but related medical care is important for healthcare providers. In nursing home care, patients are treated at a 24/7 skilled nursing facility (SNF), whereas in home health care, a patient is treated in their own home, and the provider or their staff try to improve the patient’s quality of life in familiar locations, such as their own home. Moreover, billing codes such as Current Procedural Terminology (CPT) have different requirements and billing cycles for these claims, presenting unique billing challenges to in-house billing teams.

How does A2Z Billing Services handle Medicaid eligibility checks?

Our medical billing staff diligently manages the eligibility verification process by thoroughly going through the patient’s privileges under the Medicaid care plan, their phone number, residence, and requirements for prior authorizations. We also inform patients about deductibles, co-pays, etc, to comply with the No Surprises Act. By taking these steps, we ensure error-free consolidated billing that helps nursing home and wound care practices to prevent denials.

What CPT codes are most common in nursing home billing?

The common CPT codes in nursing home medical billing are as follows: 99304 (Initial care for new or established patient) 99305 (Moderate medical care decision-making complexity) 99306 (High medical care decision-making complexity) 99307 (Follow-up visits and exam) 99308 (Complex follow-up visit)

How do you reduce claim denials for long-term care facilities?

AR’s nursing home billing services employ different strategies to reduce claim denials, starting from error-free billing and demographic entries to the latest and accurate ICD-10, CPT/HCPCS, and revenue codes. Our nursing home billing staff scrubs the claim for any errors before electronic submission to reduce the billing cycle and reimbursement delay. Our revenue cycle management services combine efficiency and experience in reducing claim denials by more than 50%.

Do you provide provider enrollment and credentialing for nursing homes?

Our nursing home medical billing comprises the industry’s leading credentialing services for nursing homes and wound care practices. We help providers in creating a CAQH profile, its maintenance for enrollment in different in-network, out-of-network programs to increase your earnings and patient pool.

Can you handle multi-facility or multi-state nursing home billing?

Nursing home services of the A2Z medical billing company are available throughout all 50 states of the US. Our RCM staff is experienced and skilled to handle all nursing care facilities, including multi-facility and multi-state locations. With our help, large-scale healthcare organizations can easily function without the need to hire multiple billing companies for their facilities.

How secure is my patient data with A2Z Billing Services?

Our nursing home medical services are HIPAA-compliant, ensuring secure/encrypted patient and financial data transmission to insurance companies for maximum security. We keep your confidential data out of reach from unauthorized access.

Do you work only with New York facilities or nationwide?

We are based in New York and offer our revenue cycle management services to all skilled nursing home facilities across the US. We help medical practices with better management of accounts receivable, a shorter billing cycle, timely payment posting, and offering financial performance analytics reporting on a monthly basis for optimized workflow.

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