Services

Skilled Nursing Facility Billing Services

End-to-end Medicare Part B billing operations for SNFs, code selection, LCD documentation, claim submission, denial management, and appeals, fully handled by a team that bills nothing else. Your in-house billers stay focused on Part A and Medicaid. We add Part B specialization without adding headcount.

Why facilities choose Burst

Specialization, not generalist RCM

We don't bill Part A, Medicaid, or physician services. Part B supply reimbursement is the entire playbook.

Extends your billing team

We integrate with your existing AR processes, we don't replace your billers, we add Part B specialization they don't need to hire for.

Contingency aligned

Our share is calculated on collected revenue, not billed charges. The math only works for both sides when claims actually get paid.

What's included

Eligibility verification, HCPCS/CPT code mapping, modifier application, claim scrubbing, MAC submission, ERA reconciliation, denial workflow, and appeals on every Part B supply claim. Reporting is consolidated monthly with full claim-level visibility, and Medicare audit defense is included on every claim we bill.

How we work alongside your team

Burst integrates with your existing EHR (PointClickCare-first) and your AR processes. We don't replace your billers, we extend them with Part B specialization they don't need to hire for, on a risk-free billing model that only charges once collections land.

Who does what: the split between your business office and ours

The most common onboarding question is not about software, it is about ownership. Your business office keeps everything it already owns: admissions, Part A billing, Medicaid, private pay, resident trust, and the relationship with your MAC on non-Part-B matters. Burst owns the Part B supply lane end to end — eligibility screening by resident and date, code and modifier selection, scrubbing, submission, ERA posting notes, denial work, and appeals. The handoff points are deliberately narrow: your team confirms census and payer status, and signs off on anything that needs a facility signature. Nobody on your staff is asked to learn a new coding set or run a second AR queue.

The weekly billing cycle, week by week

Part B supply billing is a rhythm, not a monthly event. Each week we pull the prior week's dispense and encounter data, screen every resident against Part A/Part B status for those dates, map items to HCPCS with the correct unit counts, apply KX, GA, and RT/LT modifiers where the documentation supports them, and scrub the batch before it goes to the A/B MAC under your institutional NPI. Remittances post the following cycle, denials route into a worked queue rather than a report, and appeals go out inside the payer's window rather than at month-end. Facilities see the same claim-level detail we do, which is what makes reconciliation against your own remittances straightforward.

How denials are worked, not just reported

The difference between a billing vendor and a billing partner shows up in the denial queue. A rejected supply line usually falls into one of a handful of buckets: eligibility mismatch on the date of service, a missing or expired certification, a unit-count error, a modifier the record does not support, or a duplicate against a bundled Part A stay. Each bucket has a defined response — correct and resubmit, pull the missing document, appeal with the clinical narrative, or write the line off and log the root cause. What we do not do is hand you a denial report and call it visibility. Because our fee is contingent on collections, an unworked denial costs us exactly what it costs you.

What this replaces, and what it does not

This service is not a full-RCM outsourcing engagement and we do not position it as one. We do not bill Part A, we do not touch Medicaid, and we do not take over your AR function or your clearinghouse relationship for other payers. What it replaces is the internal build-out most facilities would otherwise need to capture Part B supply revenue properly: a coder who knows the supply HCPCS set, a documentation reviewer who understands LCD requirements, and someone with the time to work supply denials to appeal. That is typically one to two FTEs of specialized capacity, added without a hire, and paid for only out of revenue that gets collected.

What's included

  • Eligibility verification (Part A vs Part B status by resident)
  • HCPCS / CPT code mapping for every supply
  • Modifier application (KX, GA, RT/LT)
  • Claim scrubbing pre-submission
  • MAC + DME MAC submission
  • ERA reconciliation
  • Denial workflow and appeals
  • Monthly claim-level reporting

Frequently asked questions

  • Claims go out under your facility's institutional NPI. Burst Billing prepares, scrubs, and submits them on your behalf, so the facility remains the billing entity of record and keeps the reimbursement.
From the blog

Part B billing operations guides

All articles
Client voice
As a COO, I rely on partners who bring clarity, consistency, and real operational impact. Burst Billing is responsive, knowledgeable, and genuinely invested in driving results for our centers.
MH
Mark Hurst
Chief Operating Officer

Reviewed by Cara Hansen, Chief Operating Officer · July 2026. Service scope and facility responsibilities described here match the onboarding checklist used with live clients.

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