Nursing Home Billing Services - Skilled Nursing Billing Experts Since 2003

Nursing Home Billing Services From Skilled Nursing Specialists

MCA Medical Billing Solutions, L.L.C. has provided nursing home billing services since 2003, and skilled nursing is all we do. We are not a general medical billing company that also takes nursing home clients. Our A++ skilled nursing billers handle the full revenue cycle for nursing homes and skilled nursing facilities across all 50 states: Medicare Part A and Part B, Medicaid and state managed care plans, Medicare Advantage, commercial insurance, and private pay.

We work directly inside the systems your facility already runs, including PointClickCare, MatrixCare, and WellSky, so your administrator and owner see exactly what we see, in real time. For most facilities, full revenue cycle coverage from MCA costs less than one full-time in-house biller.

Why Nursing Home Billing Is Harder Than Other Medical Billing

A nursing home claim has more moving parts than a physician or hospital claim. A general billing vendor learns these rules on your accounts. Our billers have worked them for years:

• PDPM and the MDS: Medicare Part A pays under the Patient Driven Payment Model, so every claim depends on accurate MDS 3.0 coding, Section GG scoring, and NTA capture. See our PDPM billing optimization service.
• Consolidated billing: the facility is responsible for most services a Part A resident receives, and knowing what is included and what is excluded protects your margin. Learn more about SNF consolidated billing.
• Medicaid pending and state rules: every state runs its own Medicaid program and managed care plans, and a resident waiting on eligibility can tie up months of revenue.
• Medicare Advantage authorizations: skilled days that run past the authorized window are one of the most common nursing home denials.
• Timely filing: payer filing limits keep running while a claim sits unworked, which is how collectible AR turns into write-offs.

What Our Nursing Home Billing Services Include

MCA works as a fully integrated extension of your business office. Our nursing home billing services cover:

• Medicare and Medicaid billing, from intake and eligibility through claim submission, tracking, and cash projections
• Commercial and managed care billing, including authorization tracking and underpayment review
• Triple Check before every Medicare Part A claim, with claims out the door in 24 hours
• Denial management and appeals, with denials worked within 3 days
• Aging AR collections, worked oldest first, every day
• Payment posting within 24 hours, with daily bank reconciliation
• Resident statements and call center support under your facility’s name
• AR presentations by payer and aging bucket, weekly or monthly
• Audit support for RAC, TPE, and Medicaid reviews

How MCA Collects: Billing Theory in Practice

Fast collections in a nursing home come from routine, not heroics. Every MCA account runs on the same method, which we call Billing Theory.

Clear the backlog first. We group identical denial reasons and work them in dedicated blocks, which can resolve claims up to twice as fast as working one resident at a time.

Catch eligibility changes early. Census eligibility runs on the 1st and 15th of every month catch mid-month plan changes before they become denials.

Check status on a schedule. Each claim gets a first status check around day 7 and a second around day 15, so rejections are fixed while there is still time to file.

Log every payer call. The claim ID, call reference number, rep name, and time go into the AR notes on every call. If a claim is rejected twice for the same error, we stop resubmitting and file a formal appeal.

Audit the AR notes daily. Daily billing logs and AR note audits keep new claims from aging past 120 days.

Results Nursing Homes See With MCA

• Providence Place: more than $400,000 in old AR collected in less than 60 days. Read the Providence Place case study.
• A Midwest life plan community: $990,000 recovered and total AR cut 76%, from $1.683 million to $407,000, in under 12 months.
• Meadowlark Hills: days in AR down 6 and 90+ day aging down 31%.
• Across our clients: 98%+ first-pass claim acceptance after Triple Check, 15 to 25% AR reduction, and 30 to 40% less 90+ day aging.

The Zero AR Guarantee

Our Zero AR Initiative (ZARI) guarantee is simple: zero AR over 180 days within six months, or we work free for the remaining six months. Facilities typically gain $15,000 or more in additional monthly cash flow within six months.

ZARI works because we work every claim to resolution instead of letting it age. See the full list of reasons nursing homes choose MCA.

The guarantee holds because of the routine behind it. Once the backlog is cleared, daily billing logs and daily AR note audits keep new claims from ever reaching 180 days. That is the difference between a one-time clean-up and a business office that stays clean.

In-House Biller or Outsourced Nursing Home Billing?

Many nursing homes run billing through one person. When that biller takes vacation, gets sick, or leaves, claims stop going out and AR starts to age. A 60-day biller vacancy can leave a 100-bed facility with roughly $200,000 in aged AR. MCA replaces that single point of failure with a team of skilled nursing billers, so coverage never stops. Read our guide to SNF billing outsourcing to compare the two approaches.

Nursing Home Billing Services FAQ

What do nursing home billing services include?

Nursing home billing services cover the full revenue cycle: eligibility and intake, claim creation and Triple Check, claim submission, denial management and appeals, payment posting, aging AR follow-up, resident statements, and reporting. MCA handles Medicare, Medicaid, Medicare Advantage, commercial insurance, and private pay.

How much do nursing home billing services cost?

Pricing depends on your census and payer mix. For most facilities, MCA’s full revenue cycle service costs less than one full-time in-house biller, with no recruiting, training, or turnover costs. Contact us for a quote.

Will we have to change our software?

No. We bill inside the system you already use, including PointClickCare, MatrixCare, and WellSky, so you keep full, real-time visibility into every claim.

Can MCA clean up our old aging AR?

Yes. Aging AR clean-up is one of the most common reasons nursing homes call us. We audit your AR by payer and status, prioritize claims by timely filing risk, and work them oldest first. Most facilities see measurable progress within 30 to 60 days.

Do you bill Medicaid in our state?

Yes. MCA serves nursing homes and skilled nursing facilities in all 50 states and works with each state’s Medicaid program and managed care plans.

Ready to Take Nursing Home Billing Off Your Plate?

Talk to the team that has done nothing but skilled nursing billing since 2003. Call (866) 609-5880 or schedule a free AR review.