Revenue leak
Understated case-mix rate
Why it happens in Concord
Thin MDS undercuts the New Hampshire per-diem
How 247MBS closes it
Pre-bill triple-check on each Part A claim
Skilled Nursing billing · Concord, NH
Skilled Nursing Billing Services in Concord, New Hampshire
Skilled nursing billing services in Concord support New Hampshire's capital, where Concord Hospital discharges older, higher-acuity patients into Merrimack County nursing-facility beds and the state's home-and-community waiver keeps only the residents who genuinely need skilled care in those beds — and 247 Medical Billing Services (247MBS) has managed that institutional revenue cycle since 2005. We run Medicare Part A per-diem, MDS-driven case-mix, and consolidated billing for freestanding, non-profit, and long-term custodial skilled nursing operators across the Concord area, 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 Concord practices
Part A Stays
Part B Therapy
PDPM
Consolidated Billing
Medicare Advantage
And More
Why Concord Facilities Outsource SNF Billing to 247MBS
Capital-area operators reach the point of outsourcing when the MDS schedule, the New Hampshire Medicaid case-mix cycle, the patient-liability reconciliations, and the Medicare Advantage authorizations can no longer stay current inside a small business office — a familiar strain in a market of mostly modest, community-rooted homes. As a specialized medical billing services company built for institutional long-term care, 247MBS runs the full revenue cycle — eligibility verification, MDS and PDPM billing support, denial management, credentialing, and A/R recovery — under one accountable team. The metrics are 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 held under 25. A 98% client-retention rate reflects the professional, consistent work we have delivered since 2005. As a billing services company fluent in New Hampshire's case-mix Medicaid and PDPM, we are not a general billing company learning on your census — use the national SNF billing hub for the full institutional model and review our footprint on the New Hampshire billing overview.
Why Concord Skilled Nursing Facilities Bill Differently
New Hampshire's long-term-care design gives Concord a distinctive billing profile. The state's Choices for Independence waiver deliberately shifts residents who can be supported at home into community settings, so the people who do land in a nursing-facility bed tend to be sicker and more skilled-care-dependent. That raises acuity and makes accurate MDS coding even more consequential, because New Hampshire Medicaid pays nursing facilities on a case-mix per-diem drawn from those assessments, on a fee-for-service basis. The same MDS also sets the Medicare Part A rate under PDPM, so one assessment scores two payers, and a thin or late MDS quietly reduces both.
Two more New Hampshire realities shape the work in Concord. Patient liability must be posted correctly each month before Medicaid pays its share of a long-stay resident's care. And because the waiver screens residents for level of care, documentation of the skilled and custodial need has to be airtight — a level-of-care question that is not answered cleanly in the record becomes a payment question later. For a capital-area home running lean, a billing company that does not know New Hampshire's case-mix rules and CFI screening is a liability, not a partner.
How a Skilled Nursing Claim Gets Paid in Concord
Under the Patient-Driven Payment Model, Medicare Part A pays a daily rate assembled from five case-mix components, each set on the resident's assessment and carried onto the institutional claim. The table traces a Concord Part A stay from assessment to payment.
| Stage | What drives the rate | Where it appears on the claim |
|---|---|---|
| Case-mix scoring | 5-day MDS scores PT, OT, SLP, Nursing, NTA | HIPPS code on revenue code 0022 |
| Daily per-diem | PT and OT taper after day 20; NTA weighted to first 3 days | Bill type 21X on the 837I |
| Coverage window | Qualifying 3-day inpatient stay; up to 100 benefit days | Days 1-20 full, 21-100 daily coinsurance |
| Part B fallback | Resident off Part A or benefit days exhausted | Bill type 22X with therapy modifiers |
| Consolidated billing | Bundled ancillaries versus separately billable 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 Concord, NH — 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.
Thanks — we’ve got it.
A SNF specialist will reach out within one business day.
Where Concord Nursing Homes Lose SNF Revenue
With a higher-acuity, case-mix-driven census, the leaks that hurt most in Concord are documentation and coordination errors that undercut the per-diem. The table lists what we correct most often for Merrimack County operators.
Revenue leak
Level-of-care denial
Why it happens in Concord
Skilled and custodial need not documented cleanly
How 247MBS closes it
Documentation review against CFI level-of-care rules
Revenue leak
Short-paid patient liability
Why it happens in Concord
Monthly amount not posted before Medicaid billing
How 247MBS closes it
Liability reconciliation on every long-stay account
Revenue leak
Denied MA continued stay
Why it happens in Concord
Concurrent-review or NOMNC deadline missed
How 247MBS closes it
Authorization and continued-stay tracking
Revenue leak
Consolidated-billing error
Why it happens in Concord
Bundled ancillary billed separately, or excluded service missed
How 247MBS closes it
Bundled-versus-excluded review before submission
Nursing Home Billing Services in Concord We Serve
Our Concord clients reflect the capital region's provider mix. We bill for long-term custodial nursing homes carrying heavy New Hampshire Medicaid and dual-eligible caseloads, freestanding for-profit SNFs, and short-stay rehab-to-home buildings turning census off Concord Hospital and the surrounding referral network. We also support non-profit and county nursing facilities, hospital-affiliated skilled units, memory-care-heavy homes, and higher-acuity subacute wings managing complex NTA-driven residents across Merrimack County and neighboring towns. Whether a client runs one Concord building or a small group across central New Hampshire, we apply one consistent, dedicated-team process rather than uneven, building-by-building billing.
Medical Billing for Skilled Nursing Facilities in Concord
A higher-acuity census makes every assessment count, and medical billing for skilled nursing facilities in Concord turns on capturing the full case-mix rate the state actually owes. 247MBS runs the complete institutional cycle for Merrimack County operators — scoring the MDS to New Hampshire's case-mix per-diem, reconciling monthly patient liability before Medicaid pays its share, documenting skilled and custodial need against Choices for Independence level-of-care rules, and tracking Medicare Advantage continued-stay review on rehab admissions from Concord Hospital. That discipline holds days in A/R under 25 and delivers a 99% first-pass clean-claim rate, so a lean capital-area office is never the reason a claim is short-paid.
Choosing a Skilled Nursing Billing Services Provider in Concord
Skilled Nursing billing across New Hampshire
Concord practices are billed out of the same New Hampshire desk. Statewide payer detail lives on the New Hampshire page.
Statewide
Medical billing for Skilled Nursing Facility practices in New Hampshire — the payer programs, authorities and rules behind every Concord claim.
Specialty hub
Outsource Skilled Nursing Facility Billing — the codes, unit rules and denials nationally, without the local layer.
Frequently Asked Questions
New Hampshire Medicaid pays nursing facilities on a case-mix per-diem drawn from MDS assessments, on a fee-for-service basis. We bill those custodial dollars directly to the state so the full case-mix rate is captured for your Concord residents.
Indirectly, yes. Because the waiver moves lower-need residents into the community, your beds skew higher-acuity, and level-of-care documentation carries more weight. We review that documentation against the state's screening rules before claims go out.
Yes. Long-stay New Hampshire Medicaid residents owe a monthly amount that must be posted before Medicaid pays the balance, and we reconcile it every cycle so custodial claims are not short-paid.
Before any Part A claim drops, we reconcile the MDS, therapy and nursing documentation, physician orders, and census and eligibility, catching classification and consolidated-billing errors while they are still fixable.
PDPM components·MDS schedule·consolidated billing·benefit days
Ready to get more Concord claims paid on the first pass?
From solo practices to multi-provider groups, we bill Skilled Nursing for Concord 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