LONG-TERM CARE SERVICES

Long-Term Care Services Billing Built Around Resident Care, Documentation, and the Complete Revenue Cycle.

Specialty-focused long-term care medical billing, coding, claims, denial management, and revenue cycle support for nursing facilities, skilled nursing facilities, long-term care organizations, and post-acute providers managing resident care, skilled services, rehabilitation, MDS documentation, PDPM workflows, and payer claims.

Get Started Explore Services

LET'S CONNECT

Talk to Our Long-Term Care Billing Team

Tell us about your nursing facility, long-term care organization, payer mix, and billing requirements.

WHY LONG-TERM CARE BILLING IS DIFFERENT

Long-Term Care Revenue Cycles Connect Resident Care, Assessments, Coverage, and Complex Payer Rules.

Long-term care billing depends on the care setting, resident status, payer, documented services, assessments, care plans, skilled needs, and applicable billing requirements.

Resident Coverage

Coverage can differ between Medicare skilled care, Medicaid, commercial insurance, managed plans, and private-pay arrangements.

Skilled vs. Custodial Care

Billing workflows must distinguish documented skilled services from long-term custodial care and applicable payer coverage.

MDS & Resident Assessment

MDS 3.0 and resident assessment information can connect clinical characteristics, care planning, classification, and payment workflows.

PDPM Classification

Skilled nursing facility Part A workflows use PDPM and related assessment and ICD-10-CM information for resident classification.

Consolidated Billing

SNF consolidated billing can place billing responsibility on the facility for many services furnished during a covered Part A stay.

Documentation & Compliance

Accurate clinical documentation, physician orders, therapy records, assessments, and care plans support claim review and billing accuracy.

LONG-TERM CARE MEDICAL BILLING SERVICES

Long-Term Care Billing Services Across Eligibility, Coding, Claims, Payments, and A/R.

Our long-term care medical billing workflow connects resident intake and payer verification with coding, claim preparation, payment posting, denial management, and accounts receivable.

Insurance Verification

Verify coverage, benefits, payer information, eligibility, and applicable resident financial responsibility.

Long-Term Care Billing

Organize resident services, billing information, claim data, and payer-specific requirements.

Long-Term Care Coding

Connect documented diagnoses and services with ICD-10-CM, HCPCS, and applicable coding requirements.

Long-Term Care RCM

Coordinate the complete revenue cycle from resident intake and billing through payment and A/R resolution.

Claims Submission

Prepare, review, scrub, submit, and monitor nursing facility and applicable skilled care claims.

Denial Management

Review eligibility, coding, documentation, coverage, consolidated billing, and payer-processing issues.

Payment Posting

Post ERA and EOB transactions, adjustments, payer payments, balances, and applicable resident responsibility.

A/R Follow-Up

Monitor aging claims, payer follow-up, underpayments, unresolved balances, and outstanding long-term care A/R.

SKILLED NURSING & REHABILITATION

Long-Term Care Billing Support for Skilled Nursing, Therapy, and Post-Acute Care.

Skilled nursing and rehabilitation services can involve resident assessments, therapy documentation, physician orders, diagnosis coding, payer requirements, and SNF payment workflows.

Skilled Nursing

Billing support for documented skilled nursing services, clinical needs, physician orders, and applicable payer workflows.

Physical Therapy

Support for documented PT services, treatment information, therapy coding, and claim preparation.

Occupational Therapy

Coding and billing workflows for documented OT services, functional treatment, and resident rehabilitation.

Speech-Language Pathology

Support for documented speech-language pathology services, diagnosis information, therapy records, and billing.

Post-Acute Rehabilitation

Coordinate hospital-to-SNF documentation, skilled services, therapy, claims, and payer requirements.

Skilled Care Classification

Review billing workflows in relation to documented skilled services, resident assessment, and applicable classification rules.

Therapy Documentation

Organize documented therapy information and billing data for claim review and payer processing.

Skilled Facility Claims

Support claim preparation, rejection handling, payer follow-up, and A/R for applicable skilled care services.

Resident → Assessment → Skilled Services → Documentation → Claim

RESIDENT CARE & CLINICAL SERVICES

Billing Support for Resident Care, Chronic Conditions, Nursing Needs, and Functional Support.

Long-term care organizations may manage residents with chronic conditions, functional limitations, complex nursing needs, and changing clinical requirements. Billing workflows need to remain connected to documented resident care.

Discuss Your Long-Term Care Workflow →

Chronic Disease Management

Support documentation and billing workflows related to ongoing resident medical conditions and care needs.

Complex Nursing Care

Review documented nursing services, clinical interventions, physician orders, and applicable billing information.

Wound Care

Connect documented wound assessment and treatment services with coding, documentation, and claim workflows.

Medication Management

Support billing workflows associated with documented medication-related management and resident care.

Fall Prevention

Review resident documentation and applicable services related to functional safety and fall-risk management.

Mobility & Functional Care

Coordinate documentation around mobility, activities of daily living, therapy, and functional support.

Respiratory Support

Support documented respiratory-related services, clinical needs, and applicable billing workflows.

Transitional & Post-Acute Care

Connect hospital discharge information, skilled services, resident assessments, and billing requirements.

NURSING FACILITY & RESIDENT SERVICES

Long-Term Care Billing Support Across Nursing, Therapy, Physician, and Resident Services.

A nursing facility revenue cycle can span multiple clinical and operational services. Accurate billing requires these services to remain aligned with resident records and payer requirements.

NURSING

Nursing Facility Services

Support documented resident nursing services, clinical records, orders, and billing workflows.

PHYSICIAN

Physician Services

Coordinate applicable physician documentation, visits, diagnoses, and claim-related information.

THERAPY

Rehabilitation Services

Billing workflows for physical, occupational, and speech-language pathology services.

RESIDENT CARE

Daily Resident Care

Organize documented resident care information within applicable long-term care billing processes.

CARE PLAN

Care Plan Support

Connect documented care-plan information with billing and review workflows.

MEDICAL

Medical Management

Support billing workflows around documented medical management and resident conditions.

POST-ACUTE

Post-Acute Services

Coordinate hospital discharge, SNF admission, skilled care, therapy, and billing information.

FACILITY

Facility Billing Operations

Connect resident-level transactions with claims, payments, denials, and accounts receivable.

MDS, ASSESSMENT & PDPM

Connect Resident Assessments, MDS Documentation, Care Plans, and PDPM Billing Workflows.

For applicable skilled nursing facility workflows, resident assessment information can connect clinical characteristics, diagnosis data, care planning, classification, and payment processes.

MDS 3.0

Support billing workflows that depend on accurate resident assessment information and current MDS processes.

Resident Assessment

Connect resident assessment information with clinical, coding, classification, and billing workflows.

Care Plans

Align documented resident needs, services, goals, and care-plan information with billing review.

PDPM Classification

Support workflows involving the Patient-Driven Payment Model, applicable assessment information, and classification requirements.

ICD-10-CM Mapping

Review documented diagnoses and applicable ICD-10-CM information used within relevant SNF payment workflows.

Clinical Categories

Organize documentation and billing information around applicable resident clinical classification categories.

Functional & Cognitive Information

Connect documented functional and cognitive information with assessment and billing workflows where applicable.

Documentation Review

Review clinical documentation for consistency across assessment, coding, claims, and payer requirements.

LONG-TERM CARE MEDICAL CODING

Long-Term Care Coding That Connects Resident Documentation to the Correct Billing Workflow.

Long-term care and skilled nursing coding should follow the documented diagnosis, resident status, services provided, assessment information, payer rules, and applicable claim requirements.

ICD-10-CM Diagnosis Coding

Review documented resident diagnoses and applicable ICD-10-CM requirements for the relevant billing workflow.

CPT & HCPCS Coding

Support applicable physician, therapy, procedure, supply, and HCPCS-related billing workflows.

MDS Coding Review

Connect assessment information and documentation with applicable classification and billing workflows.

PDPM Coding Support

Review documented diagnosis and clinical information used in applicable PDPM-related billing processes.

Consolidated Billing

Review services against applicable SNF consolidated billing requirements and current CMS code files.

Revenue Code Review

Support claim preparation involving applicable revenue codes, billing data, units, and payer requirements.

Documentation & Medical Necessity

Review clinical records, orders, therapy documentation, and medical necessity information supporting billed services.

Claim Editing & Compliance

Review claims for coding, documentation, payer, consolidated billing, and claim-processing issues.

Resident Record → Assessment → Diagnosis → Coding → Consolidated Billing → Claim

INSURANCE & COVERAGE VERIFICATION

Long-Term Care Insurance Verification and Coverage Support Before Claims Reach the Payer.

Long-term care organizations may work with Medicare, Medicaid, commercial plans, managed care organizations, private-pay arrangements, and other payer pathways depending on the resident and service.

Eligibility Verification

Confirm coverage, benefits, payer identity, resident information, and applicable eligibility requirements.

Medicare Coverage Review

Review applicable Medicare skilled-care coverage and claim requirements for qualifying SNF workflows.

Medicaid Verification

Support Medicaid eligibility and payer-information workflows according to applicable state and program requirements.

Managed Care Review

Review plan-specific benefits, network information, authorization, documentation, and claim requirements.

Coverage Coordination

Coordinate payer information across facility records, resident services, claims, and billing workflows.

Claim Readiness

Review coverage, documentation, coding, services, and payer requirements before claim submission.

VERIFY → REVIEW → DOCUMENT → VALIDATE → SUBMIT

LONG-TERM CARE REVENUE CYCLE MANAGEMENT

A Connected Billing Workflow From Resident Admission to Final A/R Resolution.

Long-term care billing continues beyond claim submission. Rejections, documentation issues, coding questions, payer processing, payment posting, denials, underpayments, and aging A/R all require structured follow-up.

Verify

Eligibility, benefits, coverage, payer, and resident information.

Authorize

Applicable managed-care, skilled-service, and payer requirements.

Capture

Resident services, assessments, therapy, nursing, and documented charges.

Code

ICD-10-CM, CPT, HCPCS, revenue codes, and applicable billing data.

Review

MDS, documentation, care plans, PDPM, medical necessity, and payer rules.

Submit

Clean claim submission, monitoring, and rejection management.

Resolve

Denials, payments, adjustments, underpayments, and A/R follow-up.

PRACTICE TYPES

Long-Term Care Billing Across Different Facility Models

Billing workflows can be structured around facility type, resident population, payer environment, skilled services, and operational requirements.

Long-Term Care Facilities

Skilled Nursing Facilities

Nursing Home Organizations

Multi-Location Nursing Facilities

Post-Acute Care Facilities

Rehabilitation-Focused SNFs

Hospital-Affiliated Skilled Nursing Facilities

Long-Term Care Provider Groups

FREQUENTLY ASKED QUESTIONS

Long-Term Care Billing FAQs

What Long-Term Care Services do you support? +

We support long-term care billing workflows including eligibility verification, nursing facility billing, coding, claims, payment posting, denial management, accounts receivable, and revenue cycle management.

Do you provide nursing home billing services? +

Yes. Nursing home billing workflows can include resident information, payer verification, claim preparation, payment posting, denial follow-up, and A/R management.

Do you support skilled nursing facility billing? +

Yes. Applicable skilled nursing facility workflows can include resident assessment, coding, PDPM-related billing, claims, consolidated billing review, and payer follow-up.

Do you provide long-term care coding services? +

Long-term care coding workflows can connect documented diagnoses and services with ICD-10-CM, CPT, HCPCS, revenue codes, and applicable payer requirements.

Can you support MDS and PDPM billing workflows? +

We support billing-related workflows that need to remain aligned with MDS documentation, resident assessment information, PDPM classification, diagnosis coding, and applicable SNF requirements.

What is SNF consolidated billing? +

SNF consolidated billing is a Medicare billing requirement under which the facility generally has billing responsibility for many services furnished during a covered Part A SNF stay, subject to applicable statutory and regulatory exclusions.

Do you support Medicare and Medicaid long-term care billing? +

Billing workflows can be organized around Medicare, Medicaid, commercial insurance, managed care, and other payer requirements, with applicable coverage and program rules reviewed separately.

How do you handle long-term care claim denials? +

Denials can be reviewed for eligibility, documentation, coding, coverage, consolidated billing, payer-processing, and other claim-level issues before correction or appropriate follow-up.

Do you provide long-term care payment posting? +

Yes. Payment posting workflows can include ERA and EOB review, payer payments, contractual adjustments, balances, and remaining A/R.

Can you manage long-term care accounts receivable? +

Long-term care A/R workflows can include aging review, payer follow-up, unresolved claims, underpayment review, and escalation of outstanding balances.

RESIDENT CARE Nursing, therapy, skilled services, assessments, and care documentation.

DOCUMENTATION MDS, care plans, resident records, orders, and clinical review.

CODING ICD-10-CM, CPT, HCPCS, revenue codes, PDPM, and claim alignment.

RCM Claims, denials, payments, underpayments, and A/R resolution.

LONG-TERM CARE BILLING SUPPORT

Build a More Connected Long-Term Care Revenue Cycle.

Bring resident information, documentation, coding, claims, payment posting, denial management, and A/R into one structured long-term care billing workflow.

Talk to Our Team →