Billing for skilled nursing facilities is not general billing with a different code set. Case-mix classification driven by assessment data, where the assessment itself sets the payment rate.
Consolidated billing makes the facility responsible for most services, and Medicaid is the dominant long-stay payer in most states.
At a glance
What drives the coding
Case-mix classification driven by assessment data, where the assessment itself sets the payment rate.
What drives the payer behavior
Consolidated billing makes the facility responsible for most services, and Medicaid is the dominant long-stay payer in most states.
Coding
Assigned by certified coders from your documentation.
Reporting
Denials segmented by reason, payer, and provider.
Where skilled nursing facilities claims actually fail
- Assessment not completed inside the required window
- Services billed separately under consolidated billing
- Skilled level of care not documented daily
How we work it
We code from what your record documents and query you when it does not support a code, which in skilled nursing facilities is where most of the avoidable exposure sits.
Denials are worked by cause rather than in queue order, so the same failure stops recurring instead of being re-worked every month.
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your current skilled nursing facilities denials and aging.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes reported monthly, segmented by payer.
Skilled Nursing Facilities Medical Billing by State
Medicare contractor, Medicaid program and managed-care structure, and no-fault rules cadence differ by state. Pick yours for a state-specific guide.
Skilled Nursing Facilities — Frequently Asked Questions
Do you have coders who know skilled nursing facilities?
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Yes. All coding is performed by certified coders, and specialty assignment is deliberate — case-mix classification driven by assessment data, where the assessment itself sets the payment rate.
Do you guarantee we will collect more?
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No, and nobody honestly can. Payment is decided by the payer. What we commit to is the process and the six numbers we report, which you can check against your own system.
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