Specifications include, but are not limited to: The Contractor will electronically create, bill, and collect for services of claims with dates of service provided by Mountain View Community nursing home. The Contractor will create and submit claims to Medicare, nurse practitioner, private insurance including billing and collection of related nonprivate coinsurance and deductible amounts within 15 days of complete information related to claims. The Contractor will submit timely billing and provide collections related to Medicare Part A and Medicare Part B, Medicaid, commercial insurance, coinsurance/deductible claims, nurse practitioner billing, private pay, and collections. Contractor will perform the following: Charge entry Create and submit Medicare Part A and Medicare Part B claims Create and submit Medicaid claims Create and submit nurse practitioner claims Create and submit non-private Medicare coinsurance and deductible claims Payment posting for related claims Assist with the preparation and submission of quarterly balance reports Provide monthly reports and aging reviews Provide feedback to the management team regarding the facility’s performance, potential documentation problems, and potential compliance issues Assist in preparing quarterly credit balance reports relative to claims billed Ensure there are monthly reports on billings, collections and aged receivables Assist with report generation and provide information for the cost report Ensure data integrity of electronic billing files Perform collection procedures on unpaid or underpaid claims billed Provide clinical review to assure Medicare A and B documentation supports claims
