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Manage your assisted living facility with expert billing solutions designed for the unique services provided to residents, including personal care, medication management, and supportive living arrangements. Focus on comprehensive resident care while we handle your assisted living medical billing, including accurate coding (utilizing CPT, ICD-10, and HCPCS codes specific to assisted living and long-term care) and efficient claims management.
Assisted living facilities involve a broad spectrum of services – from daily living assistance (ADLs) and medication administration to recreational activities and health monitoring for a diverse resident population. These services often have specific billing requirements, payer rules (including private pay, long-term care insurance, and potential Medicaid waivers), and meticulous documentation needs for care provided. Our specialized approach identifies accurate coding, minimizes claim denials, and keeps your assisted living facility billing efficient and your revenue cycle management robust.
Managing varied resident care plans, differing levels of service, and complex billing structures across multiple payers (private, LTC insurance, Medicaid) can overwhelm standard billing systems.
Finding billing staff skilled in specific codes for personal care, skilled nursing services (if applicable), and understanding payer-specific rules for assisted living reimbursement is critical for RCM success.
Incorrect coding for levels of care, non-covered services, or insufficient documentation of services rendered can lead to significant revenue leakage and audit risk.
Tracking and collecting monthly fees, co-pays, and out-of-pocket costs for additional services from residents or their responsible parties is essential for maintaining positive cash flow.
Navigating long-term care insurance policies, varying deductibles, and complex Medicaid waiver programs requires precise benefit verification and continuous eligibility checks to minimize claim denials.
Denials due to lack of authorization, medical necessity (for any skilled services), or documentation discrepancies demands prompt, specialized follow-up and appeals expertise.
Perform specialized audits to guarantee accuracy and compliance for personal care services, medication management, and other supportive care provided within assisted living settings.
Improve your assisted living billing process with our targeted claims submission and scrubbing services. We identify errors (including those related to service levels and payer requirements) before claims leave your system, reducing denials and making sure every service is billed correctly.
Simplify charge entry for the wide range of assisted living services. Our system accurately captures basic monthly fees, additional care services, and other billable items, making sure every service is reflected in your billing for timely payment.
Efficiently post payments (including Electronic Remittance Advice – ERA and Explanation of Benefits – EOB) for all assisted living services. Our streamlined process reconciles payments quickly, enhancing your overall revenue cycle management.
Utilize our specialized process for managing and appealing denied assisted living claims, addressing Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs). We review claim denials, address coding errors or documentation deficiencies, and promptly resubmit claims to get every dollar owed.
Optimize your collections with proactive accounts receivable management and follow-up on aging AR. Our systems reduce outstanding balances and see that resident accounts are managed efficiently, supporting your facility’s cash flow.
Net Collection Rate
of A/R Less than 30 days
Clean Claims on First Submission
Increase in Practice Collection
or Less Initial Denial Rate
Deliver valuable insights and training to help your staff better manage claims, post payments and. develop standard operating procedures.
Provide fully customized consulting services to medical providers that include medical billing, coding, credentialing, and practice management analytical that help profitability.
Get expert support to navigate the complex process involved in enrolment and credentialing, all at an affordable cost.
Let us manage your billing challenges so you can devote your energy to providing exceptional care and fostering a supportive community for your residents. Our expert RCM services promise a smooth revenue cycle and maximized reimbursements.