+1 (307) 209-2667
info@hhsbilling.com
30 N Gould St Ste R, Sheridan, WY 82801, USA
Nursing Home/SNF Billing Services
Contact US
What We Do:
Timely submission of UB-04 and CMS-1500 claims
End-to-end RCM for both Medicare Part A and Part B SNF claims
Accurate benefit verification for long-term and post-acute care
Coordination with therapy departments and MDS teams for accurate billing
HIPAA-compliant workflows with complete audit support
RCM Expertise for the Complex Needs of Skilled Nursing Billing
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Submitting Part B outpatient claims for ancillary services like lab tests and radiology
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Coordinating Minimum Data Set (MDS) schedules to support accurate RUG-level billing
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Managing consolidated billing exceptions and therapy cap tracking
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Handling split billing across multiple payer types (Medicare, Medicaid, and private)
Billing for SNFs and nursing homes is significantly more complex than standard outpatient medical billing. It involves navigating Medicare’s Prospective Payment System (PPS), MDS assessments, consolidated billing, and strict timelines for filing claims. At Horizon Healthcare Solutions, we specialize in these requirements, ensuring your facility gets paid accurately and on time.
Our team collaborates with your clinical and administrative staff to ensure correct data collection, timely documentation, and error-free claim submissions. Whether it’s a long-term care resident under Medicare Part A or outpatient therapy under Part B, we handle the full revenue cycle with precision.
We also stay compliant with HIPAA and CMS guidelines while using leading long-term care EHR and billing systems. Horizon provides detailed AR tracking, denial management, and reimbursement forecasting to maintain healthy financial outcomes.
Common Challenges in Nursing Home / SNF Billing
01
Complex Medicare Regulations
Medicare SNF billing involves PPS rules, timely MDS coordination, and frequent updates to payment models like PDPM.
02
Split Billing Confusion
Facilities often struggle with separating services under Part A and Part B correctly, leading to improper payments or denials.
03
Late or Incomplete Documentation
Missing MDS assessments, therapy notes, or admission/discharge summaries can result in delayed or rejected claims.
04
Consolidated Billing Mismanagement
Failure to include all required services in the SNF’s bill or billing for excluded services can lead to compliance issues.
05
Frequent Changes in Payer Mix
Residents often shift between Medicare, Medicaid, and private insurance, creating billing inconsistencies and aging AR.
06
High Denial Rates for Ancillary Services
Diagnostics, labs, and therapy often get denied due to lack of proper authorization or supporting clinical documentation.
Let Horizon Handle the Complexity of Your SNF Billing
Horizon Healthcare Solutions brings deep domain knowledge in nursing home and SNF billing, with a team that understands the regulatory depth and operational challenges of long-term care reimbursement. From intake through discharge, our billing workflows align with your clinical practices.
We manage everything from timely UB-04 submission to claim follow-up, payer communication, and denial resolution. By staying aligned with PDPM, HIPAA, and CMS changes, we minimize financial risk while ensuring compliance.
With Horizon by your side, your nursing facility can focus on delivering compassionate, round-the-clock care while we handle your revenue flow—accurate, timely, and secure.
How We Add Value to Your Practice
Redefining Industry Excellence
HIPAA Compliant
Our commitment to HIPAA compliance ensures the highest standards of data security and patient confidentiality. We implement robust safeguards to protect sensitive information, allowing healthcare providers to focus on delivering exceptional patient care.
Proven Results and Cost Efficiency
Customized, Client-Centric Approach
Committed to Your Success
Comprehensive Claims Reviews
Regularly conducted assessments of denied claims to pinpoint submission errors and enhance future claim accuracy.
Ease and Simplicity
Our services integrate with your existing software and in-house team to ensure efficient and profit-focused processes.
Reliable Support, When You Need It
Our dedicated team is available to assist you during convenient hours and ensures prompt responses to your inquiries by phone, email or chat.
