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.

Home Health Care Medicare Billing: How Agencies Get Paid Under PDGM

Before January 2020, Medicare paid home health agencies based primarily on the volume of therapy visits provided during a 60-day episode of care. More therapy visits meant higher payment. The incentive structure was straightforward, if not always well-aligned with patient needsp. The...

Home Health Medicare Billing Guidelines: Coverage Rules, Documentation Requirements, and Compliance Essentials

Medicare home health billing operates within a specific set of coverage rules and documentation requirements that determine, claim by claim, whether the care your agency provides is reimbursable. These guidelines are not aspirational standards they are the criteria against which every claim...

Is Your Nursing Home Software Actually Improving Billing Performance or Just Processing Claims?

There is an assumption embedded in most nursing home software conversations that deserves more scrutiny than it usually receives: the assumption that having the software is the same as benefiting from it. When a skilled nursing facility implements PointClickCare, MatrixCare,or another...

SNF Software and Billing Accuracy: Why the Platform Is Only Half the Answer

If you operate a skilled nursing facility, you almost certainly run PointClickCare or MatrixCare. Between them, these two platforms serve most of the U.S. skilled nursing market. Both are sophisticated, purpose-built systems with billing capabilities that when fully utilized can significantly...

Hospice Type of Bill Codes Explained: What 81X Means and How to Use It Correctly

When a hospice organization submits a Medicare claim, one of the first things the payer reads is the Type of Bill code. It appears in field locator 04 of the UB-04 claim form, and it tells Medicare two things simultaneously: what kind of provider is submitting the claim, and where that claim...

The Top SNF Billing Software Platforms Compared – Features, Strengths, and What Each Is Best For

Choosing SNF billing software is one of the most consequential technology decisions a skilled nursing facility makes. The platform you run determines how Medicare Part A claims are generated, how PDPM case-mix codes connect to MDS assessment data, how Triple Check validation is executed...