Revenue Cycle Management for Skilled Nursing Facilities

Stay up-to-date on skilled nursing regulations along with tips and tricks to improve your medical billing from the experts at MCA.

What Happens When a Skilled Nursing Facility Misses a Timely Filing Deadline?

The answer is short and worth stating plainly at the start: the claim is denied, and the revenue cannot be recovered. There is no appeal process that overrides the timely filing deadline. There is no clinical documentation strong enough to reverse it. There is no exception for claims that...

SNF Accounts Receivable Benchmarks for 2026: What Good AR Performance Actually Looks Like

AR benchmarks in skilled nursing billing are one of those topics where the numbers get cited often and understood rarely. A facility administrator hears that days in AR should be below fifty or that the 90-day-plus bucket should be under twenty percent, writes those numbers down, and then...

SNF Consolidated Billing Exclusions List 2026: What Can Be Billed Separately and What Cannot

Consolidated billing is one of the most operationally consequential Medicare rules in the skilled nursing facility setting and one of the most consistently misunderstood. Under Medicare Part A, the SNF is responsible for billing all services provided to a covered resident under a single...

How to Prepare Your Skilled Nursing Facility for a CMS Billing Audit in 2026

A CMS billing audit does not arrive with much warning. Depending on the audit type, a skilled nursing facility may receive an Additional Documentation Request (ADR) letter with a 45-day response window, or a notification from the Targeted Probe and Educate program requesting specific medical...

PDPM Coding Errors That Cost SNFs Thousands in Lost Reimbursement

There is a category of revenue loss in skilled nursing facility billing that does not appear anywhere in a denial report, an AR aging analysis, or a cash flow summary. Claims are submitted. Claims are paid. The revenue arrives on schedule. And the facility is still losing thousands of dollars...

The MDS Documentation Errors CMS Is Targeting in 2026

The MDS assessment sits at the centre of every Medicare Part A billing decision a skilled nursing facility makes. Under PDPM, it determines the daily reimbursement rate. Under Medicare's compliance framework, it is the clinical record that auditors use to evaluate whether the care provided,...