Services

SNF Revenue Recovery Services

Most SNFs are leaving six to seven figures of eligible Medicare Part B supply revenue on the table every year. Burst's revenue recovery service surfaces it, quantifies it in writing, and recovers it under your NPI, on a strict contingency model. If we don't recover, you don't pay.

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.
12-mo
Lookback available where applicable
Risk-free
Reimbursement model
$0
Cost to assess

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

  1. 1

    Anonymized data pull

    30 minutes. Read-only PCC access or a flat-file utilization export, your choice.

  2. 2

    Reimbursement assessment delivered

    Estimate of annualized Part B supply revenue your facility may not be capturing today, based on available data.

  3. 3

    Optional: activate billing

    Same contingency terms apply. No setup fees. Billing activation timelines vary by facility readiness.

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.
From the blog

Revenue recovery field notes

All articles
Client voice
Burst delivered a 55% ROI on wound supplies across my Skilled Nursing Facilities in eight months. The model works.
CL
Chris Laymon
VP of Operations / Purchasing
55%

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.

Reclaim Revenue You're Entitled To

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