The vendor is required to provide for billing services for its Meadowview nursing and rehabilitation center.
- Specific Requirements
• Verify census, admission, discharge and transfer information as entered in the EMR. 
• Enter and post (or review posting of) room and board and ancillary charges for all payers. 
• Submit and monitor all-payer claims and billing adjustments including Medicaid, medicare, medicare advantage, MLTC, commercial insurance, coinsurance, hospice, VA, private, etc. to respective recipient. • Bill, track, and collect monthly patient liability following the facility’s collection procedures. prepare check requests for overpayments of patient liability. 
• Monitor Medicaid pending cases. prepare Medicaid redeterminations for residents for which the facility is the authorized representative. 
• Monitor managed care residents to ensure authorizations are documented and billed at the correct levels. 
• Verify eligibility and coverage for primary payer and respective deductibles and coinsurance amounts. 
• Bill and monitor medicare part b, medicare advantage part b, medicare part b coinsurance and other supplemental benefit claims. 
• Reconcile deposits and cash receipts to claims. make recommendations and ensure follow up by facility. 
• Review AR aging reports each month and follow up on under and over payments to ensure the timely submission of claim corrections and adjustments. 
• Monitor for overpayments of private room and board. prepare check requests to return overpayments.
• Reconcile monthly census to billing. 
• Manage and collect old receivables 
• Maintain medicare coinsurance bad debt log, including for dual eligible beneficiaries, in compliance with medicare cost report guidelines. 
• Prepare medicare credit balance reports for quarterly submission if required. 
• Complete representative payee reports from social security, prepare 10-day letters and other correspondence to maintain residents’ personal needs accounts. 
• Review, advise, address, and respond to HMS audit inquiries. 
• Provide a review on process, progress, and overall activity monthly for the first three months, then quarterly. 
- Contract Period/Term: 1 year
- Questions/Inquires Deadline: June 12, 2025