Skilled Nursing Facility Billing Services
“As a COO, I rely on partners who bring clarity, consistency, and real operational impact. Burst Medical is responsive, knowledgeable, and genuinely invested in driving results for our centers.”
“All SNF operators should use Burst to collect on their Part B supplies. They work hard and efficiently to recover revenue that is left on the table, easy to work with, responsive, and a trusted long-term partner.”
“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.”
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
Representative engagement — composite
Outsourced skilled nursing facility billing: a two-site operator adds Medicare Part B supply billing without adding staff
- Facility type
- Two skilled nursing facilities under one operator
- In-house team
- Three billers covering Part A, Medicaid, private pay
- Starting point
- Part B supplies billed inconsistently, no denial workflow
- Engagement
- Ongoing Part B supply billing operations
The situation
The operator was not missing Part B entirely — it was billing some of it, badly. Codes were selected by whoever had time, unit counts were inconsistent across the two buildings, and denials landed in a shared inbox that nobody owned. The CFO's real question was not whether to outsource, but whether a vendor could take the Part B lane without disturbing Part A, Medicaid, or the clearinghouse relationships that already worked.
How the engagement ran
- Week 1Ownership map
The split is written down before anything moves: the business office keeps admissions, Part A, Medicaid, private pay, and resident trust. Burst takes eligibility screening, supply coding, modifiers, scrubbing, submission, denial work, and appeals on the Part B lane only.
- Week 2EHR and data connection
Read access to PointClickCare is configured, dispense and census extracts are validated against a sample week, and reporting formats are agreed with finance.
- Weeks 3–4First billing cycles
Weekly batches begin. Each cycle screens residents against Part A/Part B status for the dates in question, maps items to HCPCS with correct unit counts, and applies KX, GA, and RT/LT modifiers only where the record supports them.
- Weeks 5–8Denial queue stands up
Remittances post and denials are triaged by reason rather than reported in bulk — corrected and resubmitted, documented and appealed, or written off with the root cause logged back to the facility.
- Quarter 2 onwardSteady state
Monthly claim-level reporting lets finance reconcile against its own remittances, and recurring documentation gaps are fed back to nursing leadership as a fixable list.
What changed
- Part B specialization equivalent to roughly one to two FTEs of dedicated capacity, added without a hire.
- Consistent coding across both buildings instead of two divergent local habits.
- A denial queue that is worked rather than reported — our fee is contingent on collections, so an unworked denial costs us what it costs the operator.
- The in-house billers' Part A and Medicaid workload is unchanged, which was the condition the CFO set at the outset.
Every Burst-submitted claim also carries audit defense at no additional cost, so documentation discipline and billing volume are not competing priorities.
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
- 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.
- No. Part B supply billing is a lane most SNF business offices do not run at all. We work alongside your existing Part A and triple-check processes rather than taking them over.
- In steady state, nothing new. Nurses document care as they already do in PointClickCare, and our billers work from that record. Setup is where facility time is required, mostly system access and NPI verification.
Part B billing operations guides
Improve SNF Medicare Reimbursement Accuracy Without More Staff
Learn how SNFs can improve Medicare Part B supply billing accuracy, reduce missed reimbursement, and fix documentation gaps without hiring more staff.
Read articleMedicare Part B Billing Mistakes That Cost SNFs Revenue
DMEPOS improper payments hit 24.1% in 2024, three times the Medicare average. Six billing habits drive most of it. Here is what they are and how to fix them.
Read article“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.”
Reviewed by Cara Hansen, Chief Operating Officer · July 2026. Service scope and facility responsibilities described here match the onboarding checklist used with live clients.
Map your Part B billing workflow
Share how eligibility, supply coding, denials, and remittances are handled today. We’ll identify the work Burst can own without disrupting Part A, Medicaid, or your existing business office.
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Risk-free. If you don't get paid, neither do we.
Related billing references
Coding and unit references our billing team applies to every SNF Part B claim.