SNF consolidated billing
During a covered Part A stay, many services are bundled into the facility's payment rather than billed separately. Billing them separately denies; failing to bill what IS separately payable leaves money behind.
Specialties › SNF & Long-Term Care
SNF & Long-Term Care Billing Services
Providers who round in skilled nursing and long-term care facilities face a billing problem that office-based practices never encounter: the facility's Medicare Part A stay can absorb services the physician expected to bill separately, and place-of-service rules change what is payable. Add credentialing across multiple facilities and visit-frequency scrutiny, and SNF revenue becomes very easy to lose.
What makes it hard
SNF & Long-Term Care billing challenges we solve
These are the issues that repeat every month in snf & long-term care practices — and the ones we fix at the source rather than reworking claim by claim.
Part A versus Part B stays
Whether the resident is in a covered Part A stay or a Part B/long-term custodial stay changes what the provider may bill. Getting the stay status wrong is a top denial cause.
Place of service accuracy
Skilled nursing facility and nursing facility are distinct places of service that reimburse differently. A single wrong POS code shifts payment on every visit that month.
Visit frequency and medical necessity
Subsequent nursing facility visits are scrutinized for frequency and documented necessity, particularly for high-level codes on stable residents.
Multi-facility credentialing
A provider rounding across several facilities needs enrollment aligned to each facility and payer. Gaps produce denials that look clinical but are administrative.
Coding depth
Common code families we work with
- 99304 / 99305 / 99306 — initial nursing facility care
- 99307 / 99308 / 99309 / 99310 — subsequent nursing facility care
- 99315 / 99316 — nursing facility discharge day management
- Place of service 31 (SNF) and 32 (nursing facility)
- 99495 / 99496 — transitional care management after discharge
- Advance care planning and chronic care management services
- Modifier and stay-status review against SNF consolidated billing
Listed for context only — this is not billing advice, and payer policy varies. Our certified coders work to AAPC and AHIMA standards.
Denial prevention
Top denial drivers in snf & long-term care
- Service bundled into the facility's Part A payment
- Incorrect place of service for the stay type
- Visit frequency not supported by documentation
- Provider not enrolled or linked to the facility
- Level of service unsupported for a stable resident
We root-cause denials by payer and procedure, then fix the upstream workflow so the same denial stops recurring.
Why ERG
What you get with ERG
Specialty-trained billers
Your account is worked by people who bill snf & long-term care every day — not a general pool learning your rules on your claims.
95%+ net collection rate
Relentless follow-up on every claim, with aged A/R worked rather than written off.
No long-term contract
Performance-based pricing — a percentage of what we collect. Stay because the results are good, not because you are locked in.
5–10 day onboarding
We run parallel with your current process until the transition is verifiably clean.
Human-led, AI-supported
Our certified coders work every claim; AI tools help them catch more before submission.
HIPAA-compliant throughout
Strict PHI controls, access limits and staff training across the whole workflow.
FAQ
SNF & Long-Term Care billing — common questions
Do you understand SNF consolidated billing?
Yes. Knowing what the facility's Part A payment absorbs versus what the provider bills separately is the core skill in this specialty, and it is where most SNF revenue is lost — in both directions.
Can you bill for nurse practitioners rounding in facilities?
Yes. We bill for physicians, nurse practitioners and physician assistants rounding in SNF and long-term care, with attention to the supervision and enrollment rules that differ from office-based practice.
We round across several facilities — is that a problem?
No, but it requires disciplined credentialing. We align enrollment across each facility and payer so visits are not denied for administrative reasons.
Do you also handle behavioral health visits in facilities?
Yes. Psychiatry and behavioral health rounding in long-term care is a significant part of the work we do, including the documentation standards those visits are held to.
Client results
What practices say about working with us
★★★★★Our A/R days dropped from 58 to 31 in one quarter. First time in years I actually trust my numbers.
— Sarah M., Practice Manager
★★★★★Denials were killing us. First-pass acceptance went up fast, and they tell us why a claim failed — not just rework it quietly.
— Michael R., Billing Lead
Next step
See what your snf & long-term care practice is leaving uncollected
A no-obligation A/R analysis. We review your aging, denial patterns and coding mix, then show you exactly where the recoverable revenue is.
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