Revenue leak
Wrong PDPM group
Root cause in Buffalo
Late or inaccurate 5-day MDS
How 247MBS closes it
Pre-bill triple-check on every Part A claim
Skilled Nursing billing · Buffalo, NY
Skilled Nursing Billing Services in Buffalo, New York
Skilled nursing billing services in Buffalo work a dense Western New York market shaped by Kaleida Health and Erie County Medical Center, a large stock of older non-profit and faith-based nursing homes, and a New York Medicaid system that blends fee-for-service with Managed Long-Term Care — the institutional revenue cycle 247 Medical Billing Services (247MBS) has run since 2005. We manage Medicare Part A per-diem under PDPM, MDS case-mix, consolidated billing, Medicare Advantage authorization, and Medicaid long-term care for facilities across Erie County, each backed by a dedicated account manager, a free 360° dashboard, and full HIPAA plus SOC 2 Type II protection.
HIPAACompliant
SOC 2Type II
Serving Since2005
Specialty-FocusedRCM
We bill Skilled Nursing for Buffalo practices
Part A Stays
Part B Therapy
PDPM
Consolidated Billing
Medicare Advantage
And More
Why Buffalo Facilities Outsource Skilled Nursing Billing to 247MBS
The decision to outsource usually turns on one reality: an older non-profit home running on thin margins cannot keep every Part A claim tied to a clean MDS while also clearing Medicare Advantage authorizations and reconciling New York's Managed Long-Term Care rules. As a medical billing services company built specifically for institutional long-term care, 247MBS runs the entire revenue cycle — eligibility verification, MDS and PDPM billing support, denial management, credentialing, and A/R recovery — under one accountable team. Our performance is built to plan around: a 99% first-pass clean-claim rate, up to 40% fewer denials, 90% of worked denials recovered, and days in A/R under 25. A 98% client retention rate reflects two decades of professional, consistent SNF work since 2005. As a billing services company focused on this single domain, we are not a generalist billing company learning PDPM on your dime. Review our reach on the New York billing overview, and lean on the national SNF billing hub for the full institutional model.
Why Buffalo Skilled Nursing Facilities Bill Differently
Buffalo carries one of the older institutional nursing-home stocks in the Northeast, much of it non-profit and faith-based, serving a long-tenured population with a very high dual-eligible share. That makes Medicare-primary and Medicaid-secondary coordination the everyday backbone of the census rather than an exception. New York Medicaid long-term care runs increasingly through Managed Long-Term Care plans, each with its own level-of-care, care-management, and patient-liability rules, and the institutional net-available-monthly-income calculation must be applied correctly or the balance ages. Layer in a busy post-acute referral stream from Kaleida Health and Erie County Medical Center, plus climbing Medicare Advantage penetration in Western New York, and the workload compounds. A billing partner that understands dual-eligible coordination and New York's MLTC workflow protects revenue that a generalist vendor routinely leaves stranded between two payers.
How a Skilled Nursing Claim Gets Paid in Buffalo
Medicare Part A pays a per-diem set by the Patient-Driven Payment Model, with five case-mix components fixed on the MDS and carried onto the institutional claim. The table follows a Buffalo Part A stay from assessment to paid claim.
| Billing stage | What sets the payment | Where it lands on the claim |
|---|---|---|
| Case-mix | 5-day MDS fixes PT, OT, SLP, Nursing, NTA | HIPPS code on revenue code 0022 |
| Per-diem | Variable adjustment tapers PT/OT after day 20; NTA front-loads | Bill type 21X, 837I institutional |
| Coverage window | Qualifying 3-day stay; up to 100 benefit days | Days 21-100 carry daily coinsurance |
| Part B fallback | Off Part A or benefit days exhausted | Bill type 22X with therapy modifiers |
| Consolidated billing | Bundled ancillaries versus excluded services | Occurrence and value codes applied |
Revenue review
Put a dollar figure on what your SNF claims are leaving behind.
A certified SNF billing specialist reviews your coding, unit counts, authorizations and aged A/R against the payers you actually bill in Buffalo, NY — and puts a number on what your current process is leaving on the table.
- MDS assessment schedule tied to the component rates actually billed
- Consolidated-billing exclusions separated before the claim goes out
- Benefit days and the qualifying stay verified for every admission
HIPAA & SOC 2
Back to you within one business day
No long-term lock-in
Request a Revenue Review
Tell us about your practice.
A SNF specialist will reach out within one business day.
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A SNF specialist will reach out within one business day.
Where Buffalo Nursing Homes Lose Skilled Nursing Revenue
Most preventable losses in Erie County come from a familiar set of failures. A late or thin 5-day MDS drops a Part A stay into the wrong HIPPS group, so the per-diem no longer matches delivered care. Broken dual-eligible coordination leaves Medicare-primary balances without the Medicaid secondary that should follow. An incorrect net-available-monthly-income calculation stalls managed long-term-care revenue. And a missing Medicare Advantage authorization forfeits an admission the plan never approved.
Revenue leak
Stranded dual-eligible balance
Root cause in Buffalo
Broken Medicare/Medicaid coordination
How 247MBS closes it
Crossover and secondary follow-up
Revenue leak
Aged MLTC balance
Root cause in Buffalo
Net-available-income or level-of-care gap
How 247MBS closes it
Managed Long-Term Care reconciliation
Revenue leak
Denied MA stay
Root cause in Buffalo
No prior auth or continued-stay review
How 247MBS closes it
Authorization tracking from admission
Who We Serve in Buffalo
Our Buffalo clients span Western New York's full skilled nursing mix: older non-profit and faith-based nursing homes serving long-stay dual-eligible residents, freestanding SNFs taking rehab referrals from Kaleida Health and Erie County Medical Center, hospital-based skilled units, and higher-acuity subacute buildings managing complex care. We also support county and municipal nursing facilities and long-term custodial homes carrying deep Managed Long-Term Care caseloads. We serve facilities across the region — Cheektowaga, Amherst, Tonawanda, and West Seneca — with the same dedicated model and reporting, so a single non-profit home gets the same rigor a regional operator would buy. Skilled nursing facility billing services in Buffalo, run by a team fluent in dual-eligible and MLTC work, keep more earned revenue inside the building.
Medical Billing for Skilled Nursing in Buffalo
Buffalo's older non-profit and faith-based homes keep more of every dual-eligible dollar when medical billing for skilled nursing is handled by a team fluent in New York's Managed Long-Term Care rules. We bill Medicare as skilled-primary on each Kaleida Health and Erie County Medical Center rehab referral, apply the net-available-monthly-income calculation correctly so the Medicaid secondary follows instead of aging, and tie every Part A per-diem to a clean MDS. That discipline holds days in A/R under 25 and lifts net collections toward 99% across a thin-margin Erie County census. Homes we have served since 2005 stop losing balances stranded between two payers. Request a Revenue Review → /contact-us.
Choosing a Skilled Nursing Billing Services Provider in Buffalo
Skilled Nursing billing across New York
Buffalo practices are billed out of the same New York desk. Statewide payer detail lives on the New York page.
Statewide
Skilled Nursing Facility billing services in New York — the payer programs, authorities and rules behind every Buffalo claim.
Specialty hub
Skilled Nursing Facility Billing company — the codes, unit rules and denials nationally, without the local layer.
Frequently Asked Questions
Yes. Dual-eligibles are the backbone of the Erie County census, so we bill Medicare as skilled-primary, then coordinate the Medicaid secondary for coinsurance and room-and-board, tracking crossover and follow-up so balances do not strand between the two payers.
We confirm level of care, apply the net-available-monthly-income calculation, work each plan's authorizations, and reconcile balances monthly, so custodial long-term-care revenue keeps moving instead of aging while a determination sits open.
Before any Part A claim drops, we reconcile the MDS, therapy and nursing documentation, physician orders, and census and eligibility. This triple-check catches HIPPS and consolidated-billing errors while they are still fixable — the single biggest safeguard against SNF denials.
PDPM components·MDS schedule·consolidated billing·benefit days
Ready to get more Buffalo claims paid on the first pass?
From solo practices to multi-provider groups, we bill Skilled Nursing for Buffalo practices with a dedicated account manager, certified coders and a live dashboard — so the units, authorizations and appeals that decide your month stop being the thing nobody has time for.
Prefer email? sales@247medicalbillingservices.com