Keep Resident and Payer Information Current
A resident's account may move between payer arrangements during a stay. Admission information, coverage dates and recorded service changes need to reach billing before claims are prepared.
Native RCM can coordinate eligibility and insurance verification with your facility's administrative records. Clinical eligibility and assessment decisions remain with the appropriate professionals.
SNF Billing Support Areas
- Review of resident, payer, facility and service-date information.
- Coordination of admission, discharge and payer transition records.
- Institutional claim preparation and submission tracking as scoped.
- Review of available assessment-related billing information.
- Identification of consolidated billing questions requiring further review.
- Payment posting and account reconciliation.
- Denial investigation, insurance AR follow-up and reporting.
The service plan identifies the claim types, records and responsibilities included. Professional services billed by physicians or other entities require separate consideration.
Review Consolidated Billing Responsibilities
Medicare SNF consolidated billing assigns billing responsibility for many services to the facility during a covered Part A stay, with specified exceptions. Certain therapy services can remain subject to consolidated billing during a noncovered stay.
An outside provider should not automatically submit a separate claim without reviewing the service, stay status and applicable exclusions. Native RCM supports administrative review and coordination using the relevant records and current payer guidance.
Coordinate Assessment Information Without Replacing Clinical Work
The facility's assessment and care records can influence the information used for billing. The administrative workflow should identify which records are ready and which require the facility team's attention.
Completing assessments and determining clinical findings remain with qualified facility staff. Native RCM can help coordinate the billing information supplied and flag discrepancies for review.
Follow Up on Facility Accounts With a Clear History
An unpaid claim may involve coverage dates, claim details, payer transitions or a record request. The payer's stated reason and previous account actions guide the next step.
Denial management and AR follow-up can track the response. Reports can group accounts awaiting facility records separately from those awaiting payer processing.
SNF Billing Questions
Can you support institutional claims
Yes. The claim types, facility records and systems are assessed before the service arrangement is confirmed.
Is every service for a SNF resident billed by the facility
No. Responsibility depends on the service, stay status, payer and applicable exclusions. Consolidated billing requires account-specific review.
Do you complete resident clinical assessments
No. Qualified facility staff complete clinical assessments. Native RCM supports the administrative billing workflow agreed with your organization.
Discuss Billing Support for Your Facility
Contact Native RCM to discuss skilled nursing facility billing services in Wyoming.