As a premier medical billing and financial services company, Quality Healthcare Resources fully understands the complexities posed by A/R - and the potential impact it can have on the revenue cycles of a SNF institution.

We specialize in creating innovative billing, hi-tech payer tracking, and aggressive collections solutions to help facilities maintain their financial equilibrium. By passing along the traditional A/R complexities to an experienced company that works hard to bill efficiently, streamline processes, and maximize collections rates... your facility will see a swift spike in collection rate results.

BILLING:

  • Medicare: Part A/B monthly billing with timely follow-up process for all unpaid claims.
  • Medicaid: Weekly/Monthly billing cycles analyzed with comprehensive review conducted to correct and re-bill all denials claims.
  • HMO: Levels and authorizations verified and billed accordingly; aggressive follow-up process utilized on all unpaid claims.
  • Private Pay: Billed monthly or upon admission; non-payments actively followed up on with family members; pursuit of collections when necessary
  • Income Portion: Billed monthly with internal system; direct deposit implemented to ensure all income checks are sent directly to facility
  • Cash Posting: Structured to receive all Medicaid and Medicare remits electronically; facility to send copies of all deposits. All deposits are posted in a timely manner so that an aggressive follow-up process can occur immediately.
  • Reporting: All month end census, billing, and cash are tied out with appropriate reports - including agings - sent to controller/accountant; facility will have secure, real-time access 24/7 to QHCR server.

PAYER TRACKING:

  • Medicare Admissions: Verifying A/B eligibility and available days; monitoring of last covered day and ensure payer plan after Medicare exhausts benefits.
  • Insurance Admissions: Monitoring of authorization process to ensure authorizations are current; monitoring of last covered day to ensure discharge plan or alternate payer source is in place
  • Private Pay: Residents billed upon admission; monitoring and collection attempts in place to ensure private paying residents have ample economic resources; determine if Medicaid Application will be needed.
  • Medicaid: Review application prior to submission to prevent eligibility issues or penalties; active monitoring and coordination with facility and case worker to expedite the approval process; income amounts verified; Direct Deposit sought with resident or responsible party.

PATIENT FUNDING:

  • Management: Full management and oversight of patient fund duties.
  • Posting: Detailed posting of all deposits and reimbursements taking place.
  • Reconciliation: Monthly bank records and precise reconciliation to patient fund balance listing.
  • Statements: Quarterly statements sent to responsible parties.