Long Term Care - Medical

Medical Billing And Revenue Cycle Management Solutions For Long-term Care Facilities

Long-term care providers offer a broad spectrum of services related to individuals with chronic disease or disabilities who need supervision with daily activities. At StafGo Health, we promise to offer specialized medical billing and revenue cycle management (RCM) services designed for the unique needs of long-term care practices. Our team keeps checks on complex payer rules, manages the chronic care, and does the aggressive follow-ups. Our prompt team ensures the timely submission of claims, compliance with insurance documentation requirements, and precise coding to get maximum reimbursement.

Essential CPT Code Management With Stafgo Health For Long-term Care Facilities

A highly structured and compliant approach is required in Long-term care facilities because of the ongoing and often complex nature of patient care. Use of correct CPT codes showcases the services precisely and optimizes reimbursement. At StafGo Health, our team is an expert in managing all the CPT codes related to long-term care management, including nursing facility evaluations, 99307–99310 for subsequent care visits, 99315–99316 for discharge day management, 99318 for annual nursing facility assessments, and 99490, which covers chronic care management (CCM) services—essential for patients with multiple chronic conditions. We also support accurate billing of cognitive assessment and care planning using 99483, ensuring all documentation and timing requirements are met.

Why Outsource Medical Billing And RCM To Stafgo Health For Your Long-term Care Practice?

Managing the billing process and revenue cycle operations for long-term care facilities and practices is quite complicated and complex, which involves the chronic condition management of the practices, frequent interactions with patients, and ever-evolving payer guidelines. By outsourcing your billing services to StafGo Health, your practice gains access to efficient billing professionals, robust analytics, and scalable RCM support so that your team can focus more on best patient care and keep away the administrative burdens. Our team keenly understands the nuances and advancements of long-term care billing and provides services tailored to the specific needs of long-term facilities.

Common RCM Challenges Faced by Long-Term Care Practices

High Patient Volume & Complexity - Long-term care facilities have to handle a large number of patients on a routine basis with a complex and ongoing plan. Practices may generate multiple claims in a month, and managing a high number of claims is a big task for them. Tasks like accurate tracking, coding, and billing are labor-intensive work.
Unsupported or Delayed Documentation - Incomplete or vague documentation is the prominent challenge faced by long-term facilities. On-time and thorough documentation is crucial for reimbursement for some complex CPT codes. Incomplete notes or delayed entries can cause denials or audits.
Coordination of Benefits and Payer Rules- In long-term care settings, patients are covered by multiple payers. Understanding which payer is primary, secondary, or tertiary for different services rendered is crucial yet complicated. Inconsistent coordination of benefits or misunderstanding payer-specific rules can result in underpayments or rejected claims.
Frequent Changes in Regulatory Guidelines- Staying updated with the ever-evolving Regulatory Guidelines is also a challenge faced by long-term practices. Rules for long-term care billing related to chronic care management (99490) and transitional care are kept on changing regularly.
High Denial Rates Due to Coding Errors - A lack of certified coders with experience in LTC-related billing protocols and the wrong use of E/M codes or failure in application of proper modifiers for facility-based care lead to claim denials and lost revenue.

Solving Your Long-Term Care Practices Challenges with StafGo Health

Accurate Coordination of Benefits & Payer Hierarchy- Our experienced team specializes in determining the correct payer order, whether it's primary, secondary, or tertiary payer. We make sure that claims are submitted to the correct payer on the first attempt to avoid the chances of denials.

Skilled Documentation & Coding for Extended Care - We have a team of skilled professionals, and we ensure that services such as E/M codes, therapy, and ancillary services are coded precisely and correctly, which are important for ongoing care episodes.
Medicare & Medicaid Policy Compliance - Our team makes sure that your billing is aligned with CMS guidelines and state Medicaid policies, which can help in preventing penalties and audits while simultaneously ensuring the maximum reimbursements.
Timely AR Follow-Up & Denial Resolution- We have a team of dedicated AR specialists who aggressively work on outstanding claims, quickly addressing denials related to eligibility issues, incorrect coding, or incomplete documentation, which can improve your cash flow and reduce aging AR.
Scalable Billing Systems for High-Volume Facilities - StafGo Health empowers your staff with centralized billing, performance dashboards, and transparent reporting. Our system adapts to facilities of every size. We provide scalable billing systems for High-Volume Facilities as well.