When we think of the amount of money that goes uncollected because all nursing home personnel must live in the ‘now’, the number can be staggering. This applies in situations of Medicare and Medicaid rejected claims along with what happens dealing with private insurers or managed care organizations
Living in the now sort of reminds us of the closed case in criminal investigations. The older the matter is, the less attention key personnel can give to it. Let’s face it, with every passing minute a new crime is committed and with every new admission to a nursing home a new set of funds must be collected. Of course, the cycle is constantly repeating.
This certainly adds value to the services of those who specialize in assisting skilled nursing centers to collect what may have been labeled as “uncollectable”. We call these the financial “cold cases” of the industry but to some its just another day’s work. Just ask Frank Popoli of Healthcare Consulting & Billing Solutions, Inc. (https://www.hcbsinc.com/)
Let’s face it, even with staff’s best intentions as we noted earlier in this Blog – rejected claims often are overlooked while staff juggle many other tasks concurrently. As a result, claims often become untimely and are ultimately written off. As soon as a claim is rejected, the clock is ticking. There is a small window to get claims corrected and reprocessed. Not getting claims paid for services provided should not happen. Hence the need for professional intervention.
To have studied this firm that specializes in medical claims resolution and process improvement to help your agency collect payment on services nursing homes provide was a real eye opener. Claims referred to this company are logged into a tracking system, researched and processed usually within a few days of referral. Their tickler system assures that they submit claims within the time frame required per each payer’s contract. Claims are then monitored continuously until paid to assure the best results for the client. To us, that is incredible.
We love being able to add to the success of the skilled nursing community. Getting your money in the bank is a huge part of that. Contact them and minimize your “closed cases”.
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Another Blog Post by Direct Care Training & Resource Center, Inc.
P.O. Box 249 – Wayne, MI 48184
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