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Skilled nursing facility billing

SNF billing built around PDPM & the MDS

Per-diem reimbursement, MDS-driven case-mix, consolidated billing and three payers per resident make SNF billing unforgiving. Helix reconciles HIPPS to the MDS and keeps Part A, Part B and Medicaid claims clean.

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Clean-claim rate

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Avg. net revenue lift

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Days in A/R

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Denials overturned

The SNF challenge

Per-diem money rides on the MDS

Under PDPM, your reimbursement is only as accurate as your MDS. A mis-keyed assessment, a late HIPPS reconciliation, or a consolidated-billing slip quietly costs per-diem dollars across every covered day and every resident.

Helix reconciles billing to the MDS, applies consolidated-billing edits, and coordinates Medicare, Medicaid and managed-care so the facility collects the full, accurate per-diem it has earned.

PDPM & HIPPS accuracy

HIPPS codes reconciled to the MDS for correct case-mix.

Consolidated billing

Bundled vs. excluded services billed to the right payer.

Triple-payer coordination

Part A, Part B therapy/ancillary and Medicaid room-and-board.

UB-04 & benefit periods

Accurate institutional claims and benefit-day tracking.

Codes & data we manage

The SNF billing elements that get missed

SNF revenue runs on HIPPS, revenue codes and condition codes on the UB-04, not office CPTs. We keep each element accurate and reconciled.

snf/capture.ub04MDS-reconciled
0022SNF PPS / HIPPS rate code (PDPM)MDS-driven
0120Room & board, semi-privateper-diem
0420Physical therapyPart B
0250Pharmacyconsolidated
0420Therapy (excluded service check)CB edit
G0299Skilled nursing service (home health crossover)as applicable
Representative SNF revenue/HIPPS elements. Helix maintains facility-specific consolidated-billing edits.
Denials we kill

SNF billing's four costliest denials

HIPPS · mismatch

HIPPS not matching MDS

Billed HIPPS code doesn't reconcile to the transmitted MDS, triggering RTP or recoupment.

Helix fix: HIPPS-to-MDS reconciliation check before each Part A claim drops.

CO-97 · CB

Consolidated-billing slip

A service that should be bundled into the SNF per-diem billed separately (or vice versa).

Helix fix: consolidated-billing edit routes each service to the correct claim.

CO-109 · payer

Benefit period exhausted

Part A days billed past the 100-day benefit or without a qualifying hospital stay.

Helix fix: benefit-day tracker flags exhaustion and transitions to the next payer.

CO-22 · COB

Coordination of benefits

Medicaid or managed-care billed before Medicare, or crossover not applied correctly.

Helix fix: payer-sequence rules enforce correct primary/secondary order and crossover.

How Helix bills skilled nursing

The Helix RCM Engine, tuned for SNF

01

MDS reconciliation

HIPPS validated against the transmitted MDS assessment.

02

Claim assembly

UB-04 built with correct revenue, condition and occurrence codes.

03

CB & COB scrubbing

Consolidated-billing and payer-sequence edits applied.

04

Denial recovery

RTP correction, appeals and aged-A/R workdown.

Proof, not promises

What changes when SNF billing is reconciled correctly

Maplewood Care Center
120-bed facility · Wisconsin
PDPMMDSConsolidated Billing
+20%
net revenue in 6 months
26
days in A/R (from 58)
98.2%
clean-claim rate
$430K
aged A/R recovered

"Our HIPPS codes and MDS were drifting apart and Medicaid crossovers were a mess. Helix reconciled everything and stabilized our cash flow."

Challenge

A mid-size facility with HIPPS/MDS mismatches causing RTPs, consolidated-billing errors, and a backlog of aged Medicaid and managed-care claims after a billing-staff turnover.

Solution

Helix implemented HIPPS-to-MDS reconciliation, consolidated-billing edits, benefit-day and COB tracking, and ran a 90-day aged-A/R recovery across Medicare and Medicaid.

Outcome

Clean-claim rate reached 98.2%, A/R days fell to 26, the facility recovered $430K in aged claims, and net revenue rose 20%.

Representative composite based on Helix engagement outcomes. Individual results vary.

RV
Riverbend Rehabilitation
90-bed SNF · Iowa
−74%
HIPPS/MDS RTPs
24
days in A/R (from 52)
"Return-to-provider claims were eating our staff alive. The MDS reconciliation stopped them at the source."

Result: $176K recovered in year one.

EP
Evergreen Pointe
150-bed facility · Minnesota
+18%
Medicaid net collections
98.4%
clean-claim rate
"COB sequencing was wrong on half our dual-eligible residents. Helix fixed the payer order and the money came in."

Result: +$21K average monthly Medicaid revenue.

Representative composites based on Helix engagement outcomes. Individual results vary.

Questions

SNF billing FAQ

Do you bill under PDPM and reconcile to the MDS?
Yes. We bill Medicare Part A under PDPM, reconciling HIPPS codes to the MDS assessment so case-mix and per-diem reimbursement reflect the resident's documented acuity.
Can you handle SNF consolidated billing edits?
Yes. We apply consolidated billing rules so services that must be bundled into the SNF per-diem are billed correctly and excluded services are billed separately.
Do you coordinate Medicare, Medicaid and managed care?
Yes. We manage Part A, Part B therapy and ancillary billing, Medicaid room-and-board, and Medicare Advantage authorizations, including crossover and coordination of benefits.

See what SNF billing should look like

Get a free audit of your PDPM reconciliation, consolidated billing and aged A/R, and a clear picture of the revenue you could be recovering.

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