Revenue leak
Wrong PDPM and acuity score
Root cause in New Haven
Late or thin 5-day MDS
How 247MBS closes it
Pre-bill triple-check on every claim
Skilled Nursing billing · New Haven, CT
Skilled Nursing Billing Services in New Haven, Connecticut
Skilled nursing billing services in New Haven have to work in a market shaped by Yale New Haven Health, where academic-adjacent referrals, non-profit nursing homes, and a deep Connecticut Medicaid long-stay population all meet inside the revenue cycle — and that is the institutional billing 247 Medical Billing Services (247MBS) has run since 2005. We manage Part A per-diem under PDPM, HUSKY Medicaid long-term care, Medicare Advantage authorization, and SNF Part B billing for facilities across the New Haven region, giving every client a dedicated account manager, a free 360° reporting dashboard, and full HIPAA plus SOC 2 Type II protection.
HIPAACompliant
SOC 2Type II
Serving Since2005
Specialty-FocusedRCM
We bill Skilled Nursing for New Haven practices
Part A Stays
Part B Therapy
PDPM
Consolidated Billing
Medicare Advantage
And More
The New Haven Payer and PDPM Reality
New Haven's nursing homes sit downstream of one of the busiest academic medical centers in the Northeast, so a large share of short-stay admissions arrive as post-acute rehab referrals from Yale New Haven Health hospitals. Those admissions run on Medicare Part A under the Patient-Driven Payment Model, where the 5-day MDS sets a per-diem across five case-mix components and the variable per-diem adjustment tapers therapy payment after day 20 while front-loading non-therapy ancillary payment early in the stay. Get the assessment right and the payment follows; get it late or thin and the whole stay lands in the wrong HIPPS group. Underneath that short-stay Medicare flow sits a large non-profit and faith-based nursing-home sector serving long-stay residents on Connecticut Medicaid, which pays an acuity-based, case-mix rate tied to the same MDS. New Haven also sees meaningful Medicare Advantage volume, with prior-authorization and continued-stay review rules that differ from traditional Medicare. A billing partner here has to move fluently between the academic-referral rehab stays and the Medicaid long-stay backbone without letting either slip. SNF billing services in New Haven succeed or fail on that dual fluency.
How a Skilled Nursing Claim Gets Paid in New Haven
Medicare Part A pays a per-diem set by PDPM, with five case-mix components captured on the MDS and carried onto the institutional claim. Here is how a New Haven Part A stay becomes a paid claim.
| Step | What sets the payment | Where it lands on the claim |
|---|---|---|
| MDS assessment | 5-day PPS assessment 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 days exhausted | Bill type 22X with therapy modifiers |
| Consolidated billing | Bundled ancillaries versus excluded services | Value and occurrence codes applied |
Why New Haven Facilities Outsource SNF Billing to 247MBS
Facilities choose to outsource skilled nursing billing when the business office can no longer keep the MDS schedule, the MA authorization queue, and the Medicaid long-stay reconciliation all moving together. As a specialized medical billing services company, 247MBS runs the complete institutional revenue cycle — eligibility verification, MDS and PDPM billing support, denial management, credentialing, and A/R recovery — with one accountable team behind it. Our performance is built to be planned 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 the professional, consistent work we have delivered since 2005. As a billing services company focused on institutional long-term care, we bring the workflows a non-profit New Haven nursing home actually needs, not a generalist billing company's template. Lean on the national SNF billing hub for the full model, and review our reach on the Connecticut billing overview.
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 New Haven, CT — 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 New Haven Facilities Lose Skilled Nursing Revenue
Most write-offs in the New Haven market come from a small set of avoidable failures. A late or miscoded 5-day MDS misclassifies the Medicare stay and distorts the state acuity score for Medicaid at the same time. A missing Medicare Advantage authorization forfeits an admission the plan never approved. Skilled-level-of-care documentation gaps invite denials even when the care was genuinely skilled. And unresolved Medicaid patient-liability or pending status ages the long-stay balances a non-profit home relies on.
Revenue leak
Denied MA stay
Root cause in New Haven
No prior auth or continued-stay review
How 247MBS closes it
Authorization tracking from admission
Revenue leak
Skilled-level-of-care denial
Root cause in New Haven
Documentation does not support daily need
How 247MBS closes it
Clinical-documentation review before billing
Revenue leak
Aged Medicaid balances
Root cause in New Haven
Patient-liability or pending gaps
How 247MBS closes it
Monthly HUSKY liability reconciliation
Who We Serve in New Haven
Our New Haven clients span the region's full skilled nursing mix: non-profit and faith-based nursing homes serving long-stay Medicaid residents, freestanding SNFs taking post-acute rehab referrals from Yale New Haven Health, hospital-based skilled units, and higher-acuity subacute buildings managing complex residents. We also serve smaller operators who want senior-level MDS and payer expertise without staffing a full in-house office. We support facilities across the region — Hamden, West Haven, East Haven, and Milford — with the same dedicated model, so a single non-profit home gets the same rigor a regional chain would buy. Skilled nursing facility billing services in New Haven, run by a team fluent in both academic-referral rehab and Medicaid long-stay work, keep more of your earned revenue in the building.
Medical Billing for Skilled Nursing in New Haven
Keeping both the Yale New Haven Health rehab referrals and the Connecticut Medicaid long-stay ledger fully collected is what medical billing for skilled nursing in New Haven has to deliver, and 247MBS runs each account to do exactly that. We tie every short-stay Medicare admission to an accurate MDS assessment, secure Medicare Advantage authorization before the plan can deny it, and reconcile HUSKY patient-liability month over month so long-stay balances stop aging in a non-profit home's ledger. Since 2005 our institutional teams have held a 99% first-pass clean-claim rate and days in A/R under 25 across Hamden, West Haven, East Haven, and Milford. Request a revenue review and see which stays are leaking.
Choosing a Skilled Nursing Billing Services Provider in New Haven
Skilled Nursing billing across Connecticut
New Haven practices are billed out of the same Connecticut desk. Statewide payer detail lives on the Connecticut page.
Statewide
Connecticut Skilled Nursing Facility billing services — the payer programs, authorities and rules behind every New Haven claim.
Specialty hub
Skilled Nursing Facility Billing Services Outsourcing — the codes, unit rules and denials nationally, without the local layer.
Frequently Asked Questions
Yes. Those short-stay Medicare admissions run on PDPM, so we verify the qualifying 3-day stay and benefit period, tie the per-diem to an accurate 5-day MDS, and submit the Part A claim clean. Fast, accurate rehab billing is where New Haven facilities protect their highest-value stays.
Connecticut's Medicaid rate is acuity-based and MDS-driven, so we tie every long-stay claim to an accurate assessment, reconcile patient-liability monthly, and track Medicaid-pending admissions through determination. Non-profit homes carrying deep long-stay caseloads recover the most from that discipline.
Before any Part A claim drops, we reconcile the MDS, therapy and nursing documentation, physician orders, and census and eligibility. This pre-bill 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 New Haven claims paid on the first pass?
From solo practices to multi-provider groups, we bill Skilled Nursing for New Haven 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