Is Your Skilled Nursing Facility Losing Revenue to Claim Denials and Aging A/R?
For Long-Term Care facilities, a broken RCM isn't just an annoyance—it's an existential threat.
Long term care revenue cycle management (RCM) services include authorization management, claim submission, denial management, payment posting, and accounts receivable follow-up for skilled nursing and assisted living facilities. An optimized RCM process ensures faster reimbursements, reduced denials, and improved cash flow stability.
Lost Revenue
Many nursing homes unknowingly lose between 5–10% of net revenue due to billing errors, denied claims, and delayed follow-up. Over time, these gaps compound and strain operational budgets.
Payment Delays
Across the healthcare industry, up to 30–35% of claims are denied or rejected on first submission. For skilled nursing facilities, this means delayed reimbursements and unnecessary administrative burden.
Why Revenue Cycle Management Is Critical for Long-Term Care Facilities
Long-term care facilities operate in one of the most complex reimbursement environments in healthcare. Skilled nursing facilities (SNFs) and assisted living communities must navigate Medicaid billing rules, Medicare requirements, managed care contracts, and frequent payer policy changes. Without a structured revenue cycle management process, facilities face increasing claim denials, delayed reimbursements, and aging accounts receivable.
Effective long term care revenue cycle management ensures clean claims submission, proactive denial management, and continuous AR monitoring—protecting your facility’s financial stability.
Efficient Revenue Cycle Management (RCM) is vital for the financial stability of long-term care facilities such as Skilled Nursing Facilities, and Assisted Living Facilities.. By utilizing LTCPro’s comprehensive RCM services, facilities can optimize their processes, enhance cash flow, and maintain compliance with industry regulations. This streamlined approach not only reduces administrative burdens but also allows care providers to focus on delivering exceptional services to residents.
When you partner with LTCPro, you gain access to a specialized team dedicated to improving the financial health of your long-term care center. Our RCM services are designed to enhance operational efficiency, increase revenue, and ensure compliance with industry regulations.
Our RCM Services Include:
- Front-End (Authorization): We manage patient case authorizations and verify eligibility before care is delivered.
- Claims Submission: Clean, accurate claims submitted right the first time. We are experts in Medicaid, Medicare, and private payer rules.
- Denial Management: We don’t just report denials; we fight Our team aggressively follows up on, appeals, and re-files every denied claim.
- Payment Posting & AR Follow-Up: We post payments and proactively work your AR aging report to ensure no dollar is left behind.
- Stakeholder Reporting: You get transparent, monthly reports showing your key financial health metrics (e.g., AR days, denial rate, cash velocity).
Our Long Term Care Revenue Cycle Management Process
Free Audit
1 We start with a no-obligation review of your current RCM process to identify leaks and opportunities.
Smooth Onboarding
2 Our team handles the entire transition, integrating with your existing systems to ensure zero disruption.
Stabilize & Manage
3 We take over all RCM tasks, immediately improving your cash flow and reducing your team’s administrative burden.
Optimize & Report
4 We provide ongoing analysis to continuously optimize your revenue cycle and provide full transparency into your financial performance.
Our Long Term Care Revenue Cycle Management Services Include:
LTCPro offers an extensive suite of RCM services tailored specifically for long-term care centers. Our key RCM activities include:
- Face Sheet Record of Admit: Accurate documentation of the resident’s information upon admission.
- Setting Up New Resident Accounts: Establishing comprehensive accounts for new residents to ensure accurate billing and records.
- Updating Billing, Finance & Personal Info: Regularly updating resident information to maintain accurate financial and personal records.
- Daily Census Tracking: Monitoring resident counts daily to ensure accurate billing and resource allocation.
- Posting of All Ancillary Charges: Accurately recording ancillary services provided to residents.
- Billing – Weekly and Monthly: Timely processing of billing for residents based on services rendered.
- Posting of Receipts and Private Cash: Managing and posting all incoming payments from various sources.
- Generating Private Statements: Creating clear and detailed statements for private pay residents.
- Analyzing Billed Versus Collected: Reviewing billed amounts against collected payments to identify discrepancies.
- Tracking of Unpaid Claims: Identifying and monitoring unpaid claims to ensure timely resolutions.
- Resolving Unpaid Claims: Actively pursuing unpaid claims to facilitate prompt payment.
- Review of Old & Pending Accounts: Conducting regular reviews of outstanding accounts for better management.
- Collections and Follow-Up: Implementing follow-up procedures on outstanding payments to improve collections.
- Month-End Closing: Performing month-end reconciliation to ensure financial accuracy.
- Census Building / Charge Posting: Establishing accurate census records and posting charges for services provided.
- Authorization Tracking: Monitoring and tracking required authorizations for services.
- SOC Tracker: Tracking significant changes in resident status to ensure proper billing.
- Private Statements: Generating and providing detailed statements to private pay residents.
- Statement Trackers: Maintaining logs of statements sent to monitor payment progress.
- Payment Posting / Trust Posting: Accurately posting payments to resident accounts and managing trust accounts.
- Quarterly Trust Statements: Providing detailed statements for trust accounts on a quarterly basis.
- Private Audits: Conducting audits to ensure compliance and accuracy in financial practices.
Long Term Care RCM Reports & Analytics:
To support effective decision-making and financial management, LTCPro generates a variety of essential reports, including:
- Resident Rate History: Detailed history of rates charged to residents.
- Census by Resident Name: Comprehensive census report organized by resident names.
- Census by Pay Source: Analysis of census data categorized by payment sources.
- Daily Rate Analysis: Daily assessment of rates charged for services.
- Aging Report Totals: Summary of outstanding receivables organized by age.
- Aging Report Detailed: In-depth breakdown of aging receivables.
- Cash-to-Cash Report: Analysis of cash flow over specified periods.
- Ancillary-to-Ancillary Report: Insights into ancillary service performance.
- Revenue Report (Expected Revenue): Projection of expected revenue based on current operations.
- Month End Recap Totals: Summary totals for month-end financials.
- Month End Recap Detailed: Detailed month-end reports for in-depth analysis.
- GL Posting Summary Report: Overview of general ledger postings for transparency.
At LTCPro, we are committed to delivering exceptional Revenue Cycle Management services for long-term care centers. Our comprehensive approach, tailored solutions, and dedication to excellence make us the ideal partner for your RCM needs.