Skilled nursing facilities provide an important and critical role in the healthcare community.  We provide your skilled nursing facility with expert, efficient billing services and collection services. Your skilled nursing facility is continually under pressure from every direction. PDPM, compliance with ever-changing regulations, and more chipping away at your cash every day. You can’t trust any biller to understand the unique challenges of skilled nursing.

Billing for skilled nursing requires a learning process that takes years to master and an up to date, continuing education. CMS changes the rules constantly, and playing catch-up is exhausting.

Optima Billing works with your skilled nursing facility on a daily, weekly and monthly basis to ensure every claim available is ready to be transmitted.  Your facility’s future depends on efficient, accurate billing. We never let claims “slip through the cracks.” We don’t rest until your skilled nursing facility has every single penny in your bank account – where it belongs!

 

Pre-billing audit to ensure clean claims that process the first time.

This step ensures that claims accepted are processed during the first transmission to improve your skilled nursing facility’s cash flow. We aren’t just pushing and clicking buttons — we take the entire process seriously to get you your money as fast as possible.

Electronic Submission of Claims

Medicare, Medicaid and private insurance claims are sent to payers electronically utilizing FISS DDE, state portals, ZirMed and insurance portals.

Follow Up and Collection

Tracking your money – from start to finish. We pick up the phone, work claims electronically – we do what we need to in order to get your skilled nursing facility the reimbursement it is entitled to! We’re not afraid to work to get every penny your skilled nursing facility has earned. When you partner with Optima Tortolano, you will never be taken by surprise when you look at your skilled nursing facility’s A/R. We never forget that we work for you, you don’t work for us!

Cash Posting

Accurate outstanding claims aging are important and so is the accuracy of your reports. We post remittances and adjustments directly into your EMR so that your accountant and finance department can produce your financial statements. Cash posting also allows you to have real time access and information on what is happening with your skilled nursing facility’s accounts receivables.

Medicare Credit Balance Reports

Even if your skilled nursing facility does not have a balance with CMS, the law still requires these reports to be filed quarterly. We prepare the reports and email them to you each quarter so all you have to do is print, sign and fax to your fiscal intermediary.

Reports for You and Your Nursing Facility

Your skilled nursing facility deserves to know what happens with billing, reimbursement and cash collections.  We provide reports on how much has been billed by payer source, when it was billed and how much has been collected.  Reporting can be in batches or based on individual patients depending on your skilled nursing facility’s needs.

Utilize your EMR and Policies and Procedures

You have systems in place, and we work with them to seamlessly integrate with your skilled nursing facility.  We work with you rather than against you to achieve a common goal: collecting every cent your nursing facility is entitled to.  Information is always in your control. Your skilled nursing facility will have full and complete medical records with billing histories. Our clients never have to adjust their policies and procedures to meet our needs!

Contact us today so we can collect every cent your skilled nursing facility is owed!