SNF Revenue Recovery Services
“The speed at which we started seeing results was impressive. We didn't have to wait months to understand the value, it showed up quickly and created an immediate financial lift.”
“Burst delivered a 55% ROI on wound supplies across my Skilled Nursing Facilities in eight months. The model works.”
“Before using Burst Billing, we partnered with a medical supply company who would bill Part B plans as the provider and keep the revenue for themselves. Burst Billing not only met but exceeded our expectations and truly opened our eyes to the benefits of a revenue share model. From the transparency and confidence of their leadership to the expertise of their billers, working with Burst Billing has been an overwhelmingly positive experience. They've helped us recover revenue we would otherwise have left on the table.”
What to know in 60 seconds
- We compare up to 12 months of supply utilization against what was actually billed and identify the recoverable Part B delta in writing.
- The assessment is delivered as a code-level estimate, not a sales pitch. Most facilities have a number within 30 minutes of sharing data.
- Recovery is opt-in. If you proceed, claims flow under your NPI on the same contingency terms, no setup, no monthly minimum.
- Recovery amounts depend on facility documentation, payer rules, and case mix, and are not guaranteed.
Why facilities choose Burst
Find the gap
We compare available 12-month utilization against what was actually billed. The delta is your potentially recoverable revenue.
Quantify the dollars
Every assessment ships with a code-level estimate of recoverable Part B revenue, not a sales pitch.
Recover going forward
Once active, claims flow weekly. ERAs land in your account, not ours.
Where the missed revenue lives
Documentation gaps between nursing notes and billable HCPCS codes. Supplies dispensed but never charged. Residents who roll off Part A but never get re-evaluated for Part B-eligible items. Codes billed at the wrong unit count. We surface all of it, then close the gaps through our day-to-day skilled nursing facility billing operations.
What recovery looks like
We start with a 30-minute reimbursement assessment, pull anonymized utilization data, and produce an estimate of recoverable revenue specific to your facility. If you proceed, claims start flowing within weeks under the risk-free billing model, and every recovered claim is supported by included Medicare audit defense.
The 12-month lookback window, and what falls outside it
Medicare's timely filing rule gives you roughly 12 months from the date of service to submit a claim. That single rule sets the boundary of every recovery engagement: a resident encounter from 14 months ago is unrecoverable no matter how well it was documented, while an encounter from last quarter is usually still open. This is why lookback value decays month by month — every 30 days a facility waits, another month of eligible encounters ages out of the filing window permanently. When we scope an assessment, we date-stamp the recoverable set so you can see exactly which months are still open and which have already closed.
What data we need for a lookback, and what we never touch
A recovery assessment runs on supply utilization and census data: item-level dispense records, resident payer status by date, and the clinical documentation already attached to those encounters. We do not need financial statements, staffing data, Part A case-mix detail, or your Medicaid book. Read-only PointClickCare access is the fastest route; a flat-file export works equally well for facilities that prefer not to grant system access. Data moves under a BAA and stays inside the review, and we can run the whole assessment on de-identified records if your compliance team prefers it that way.
Why recovery findings differ so widely between facilities
Two 120-bed buildings in the same state can produce recoverable estimates an order of magnitude apart. The drivers are almost never volume. They are: how consistently wound care and incontinence supplies are logged at point of dispense; whether residents rolling off a Part A stay get re-screened for Part B eligibility; whether physician orders and certifications live in the chart or in a paper binder; and whether the current biller treats supply lines as a byproduct of the Part A claim rather than a revenue stream of its own. A facility with disciplined charting and no Part B billing has the largest recoverable gap. A facility with weak charting has a documentation project first and a billing project second — and we will say so in the assessment rather than promising a number the record cannot support.
What happens to encounters we cannot recover
Not every gap becomes a claim. When an encounter lacks a physician order, a signed certification, or proof of delivery, we do not reconstruct the record after the fact — that is exactly the behavior that turns a recovery project into an audit exposure. Those encounters are reported back to you as a documentation-gap list, grouped by the specific element that was missing. Most facilities use that list as a forward-fix: tighten the four or five capture points it identifies, and the same encounter type becomes billable next month. Recovery ends at the filing window; the process improvement it exposes does not.
How it works
3 steps · risk-free- 101 / 03
Anonymized data pull
30 minutes. Read-only PCC access or a flat-file utilization export, your choice.
- 202 / 03
Reimbursement assessment delivered
Estimate of annualized Part B supply revenue your facility may not be capturing today, based on available data.
- 303 / 03
Optional: activate billing
Same contingency terms apply. No setup fees. Billing activation timelines vary by facility readiness.
Representative engagement — composite
SNF revenue recovery in practice: a 118-bed facility runs a 12-month Medicare Part B supply lookback
- Facility type
- Single-site skilled nursing facility, ~118 beds
- EHR
- PointClickCare, read-only review access
- Starting point
- Part A billed in-house; Part B supplies largely unbilled
- Engagement
- Lookback review, then ongoing billing
The situation
The business office billed Part A and Medicaid competently and had no bandwidth left for Part B. Supplies were dispensed and charted by nursing, but nothing downstream turned that documentation into a claim. Residents who rolled off a Part A stay were never re-screened for Part B-eligible items, so the gap compounded month after month. Nobody could say how much revenue was sitting in the chart, which is the usual reason a facility never starts.
How the engagement ran
- Week 1Scope and access
Read-only review access is granted in the EHR, a lookback window is set inside Medicare's 12-month timely filing limit, and the item categories in scope are agreed with the DON and business office manager.
- Weeks 2–3Documentation review
Every dispense and encounter record in the window is screened against Part A/Part B status by resident and date of service. Lines with a dated order, a supporting clinical note, and proof of delivery are separated from lines that do not have them.
- Week 4Findings review, before anything is billed
The facility receives a claim-level list of what is billable, what is not, and why. Nothing incomplete is reconstructed after the fact — where the record does not support a claim, we say so and the line is dropped.
- Weeks 5–8Staged submission
Billable claims go to the A/B MAC under the facility's institutional NPI in batches rather than one bulk file, so early remittances inform how later batches are coded and scrubbed.
- Weeks 8–12Denials and appeals
Denials route into a worked queue by reason code — eligibility mismatch, unit count, modifier support, Part A bundling — and appeals go out inside the payer's window.
- OngoingForward billing
The lookback closes and the same screening runs weekly on current census, so the backlog does not rebuild.
What changed
- The facility gets a defensible answer to "how much Part B supply revenue are we leaving behind" — grounded in its own records rather than an estimate.
- Every submitted claim carries its supporting documentation set, so a later record request is a retrieval task rather than a hunt.
- Root causes are named, not just claims recovered: which item categories were under-documented, and where re-screening after a Part A stay was being missed.
- No new headcount, no new software, and no fee until collections land under the risk-free billing model.
Recovery amounts depend entirely on census, item mix, and what the clinical record already supports — which is why the review comes before any projection, not after one.
Composite scenario. This illustrates how a typical Burst engagement is sequenced, drawn from common patterns across skilled nursing facilities. It is not a specific client, and no resident, facility, or payment figures are represented. Results vary by census, documentation quality, and payer determinations.
Frequently asked questions
- Medicare's timely filing window is generally 12 months from the date of service, so a lookback review typically covers the prior year where documentation supports the claim. Anything older is outside the filing window.
- No. A lookback uses the clinical record that already exists in your EHR. If an encounter was not documented at the time of service, it is not billed, and we tell you so rather than reconstructing a record after the fact.
- Each cycle you receive a claim-level summary showing what was submitted, paid, pending, or denied, with the resident encounter behind each line so your finance team can reconcile against remittances.
Revenue recovery field notes
When Compliance and Revenue Recovery Run Separately, SNFs Pay Twice
A documentation-first review process connects compliance and revenue recovery in SNFs: decision status framework, monthly checklist, and leadership visibility.
Read articleWhy SNFs Miss Medicare Part B Supply Reimbursement
See why SNFs miss Medicare Part B supply reimbursement, what documentation to verify, and how billing visibility can reduce missed claims and compliance risk.
Read article“Burst delivered a 55% ROI on wound supplies across my Skilled Nursing Facilities in eight months. The model works.”
ROI on wound supplies
Reviewed by Shawn Barron, Chief Revenue Officer · July 2026. Recovery figures on this page reflect claim-level outcomes on paid Medicare remittances, not modeled projections.
Request a 12-month recovery review
Tell us how your facility tracks supply utilization. We’ll outline the data needed to estimate still-fileable Part B claims before any billing engagement begins.
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Risk-free. If you don't get paid, neither do we.
Related resources and case studies
Background reading on how a Part B supply lookback is priced, documented, and evidenced.