- +1 (773) 985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
Aging patients deserve billing accuracy that matches the complexity of their care. Our geriatrics billing company provides geriatric billing services to nursing homes, assisted living centers, and long-term care doctors. Stream RCM’s coders know how to code according to the Medicare sequencing policy and guidelines regarding chronic conditions billing and multiple diagnosis claims.
Elderly patients require as much focus on their bills as on their treatment. As a geriatrics billing company, we know about the details of senior patient claims, modifiers, and documentation. Our billers have been working within skilled nursing units, home health agencies, and geriatric physician groups for many years now, gaining a lot of expertise in billing Medicare Advantage claims, dual eligible claims, and chronic illness conditions as opposed to regular adult patient billing. We understand the unique documentation levels required for chronic care management, transitional care visits, cognitive assessments, and extended time billing.
Senior care is not a single specialty, but a set of different environments for billing, each following different payer policies. This is how we bill in each setting.
Our team coordinates claims of skilled nursing facilities based on accurate Part A/Part B sequence coding, adhering to the Consolidated Billing guidelines as well as therapy caps, which cause widespread denial of claims in this field today.
Our company coordinates home health care billing, involving face-to-face encounters, episode coding based on OASIS data, and physician certification dates, making sure all claims meet the strict criteria of Medicare each time.
We code assisted living medical visits precisely for billing purposes by distinguishing custodial care from skilled billable services and recording cognitive decline assessment visits that most billing companies either miscode or ignore every month.
We understand the complexities of hospice billing, such as benefit period changes, election statements, and coding terminal diagnoses, while ensuring family members get compassionate hospice services without any billing issues.
Our company provides assistance with accurate consolidated billing, coordination of resident trust funds, and Minimum Data Set-related coding to maintain consistent payments on each certified nursing bed occupied monthly in long-term care facilities.
Our geriatrics billing associates manage every stage of the revenue cycle for senior care providers from first claim to final payment.
Our services examine each and every denial of geriatric claims to discover the reasons behind it either related to modifier problems, medical necessity problems or filing problems and then re-files the correct claims.
Our accounts receivable specialists pursue aging geriatric claims, chasing Medicare, Medicaid, and secondary insurance payments until each penny due to your practice is collected without ever writing anything off.
We perform complete medical billing audit services on all geriatric claim files to identify under coding, over coding, and any compliance issues before they cause any trouble with payers or government entities.
We have our certified coders coding for chronic illnesses, cognition assessments, and extended appointments, providing us with documentation that supports every code billed.
We facilitate provider credentialing for Medicare, Medicaid, and other geriatric-specific payers, managing your re-credentialing, enrollment management, and CAQH profile maintenance.
Our payment posting team will ensure the reconciliation of Medicare payments, secondary payer adjustments, and patient balance amounts on a daily basis to prevent any underpayment.
Let our team take over the complexity of geriatric billing so your practice collects faster and staff stress less every day.
Geriatrics practices billing process is a difficult one and something that staff members are usually unable to handle effectively while dealing with the patients they treat each day. The coding of chronic illnesses, having many diagnoses simultaneously, and the ongoing changes in policy by Medicare are things that demand time and attention that cannot be given by staff at the front desk. Geriatric billing outsourcing to our expert team allows you to gain access to experts who will not only keep up to date with the payer policies but will also appeal denials and ensure compliance while freeing up clinical staff from such burdens.
| Code Focus | How We Apply It |
|---|---|
| Wellness Visits | Our billing code for an annual wellness visit is G0438 and G0439 with chronic illness diagnosis codes, for instance, I10 to ensure that practices are paid appropriately for preventive senior care visits. |
| Cognitive Care | We use the code CPT 99483 for cognitive assessment and planning of care along with the diagnosis code F03.90 for unspecified dementia, to make sure that the memory visits are coded appropriately. |
| Chronic Management | We used chronic care management code, CPT 99490 with diagnoses such as E11.9, which is diabetes. This code represents the actual management of geriatric patients with multiple illnesses each month. |
| Bone Health | Our coders utilized M81.0 for coding visits related to osteoporosis. Such codes correspond to the right evaluation and management codes to verify that reimbursement for such services is obtained. |
| Advance Planning | The CPT code 99497 provides for advanced care planning services, which we use along with related debility diagnosis codes like R54, ensuring that end-of-life issues are appropriately coded and billed. |
Medicare Advantage enrollments among senior patients are increasing each year and have led to changes in how reimbursement is made in geriatric medical practices. The rules for prior authorization are becoming stringent, risk adjustment coding determines reimbursement, and each plan comes with its own set of requirements regarding documentation different from those of regular Medicare. Failure to adapt to the new coding and submission process results in more denials and delayed reimbursement based on these specific requirements. We keep track of any changes in Medicare Advantage payment policies and adjust prior authorization processes for geriatric visits while ensuring documentation backs up the diagnoses entered by the coder.
Your documentation will stay intact. Our team will just extract the necessary information from your system to perform coding, billing, and claim services.
Payers are now incorporating social determinants of health into risk adjustment and value-based payment models, while elderly patients are most affected by housing issues, lack of transportation, and isolation from society. It has become very crucial to capture such data through correct Z codes of ICD-10. Failure to do so might result in under-documenting the complexities of the patient which will lower the risk-adjustment payment of such practices. We assist geriatric practices in recognizing where coding related to social determinants is required and helps in capturing the Z codes in addition to the medical diagnosis.
Geriatric practices face recurring billing obstacles that quietly drain revenue if left unaddressed for long.
We built our approach around the specific realities geriatric practices face daily, so nothing ever gets rushed or miscoded here.
We train coders specifically in geriatric documentation, chronic care management, and Medicare Advantage requirements consistently every day.
We assign one consistent billing associate to every geriatric account, so your practice never repeats itself explaining preferences or history.
Our team reviews high-risk geriatric claims before submission, catching missing documentation early and reducing denials well before they ever occur.
We deliver plain-language reports that explain denial trends, aging claims, and revenue shifts specific to your geriatric patient population directly.
Onboarding typically takes one to two weeks, including claims review, denial pattern analysis, and assigning your dedicated billing associate promptly.
Yes, we review charts before submission, verify time-based code requirements, and correct documentation issues to reduce chronic care denials.
Yes, we provide regular plain-language reports covering denial trends, receivables aging, and reimbursement patterns specific to your geriatric patient population.
Yes, small practices benefit most since outsourcing removes staffing overhead while we handle coding, billing, and collections entirely instead.
Partner with specialists who understand elder care billing and help your practice get paid faster.
