Avben Healthcare Consulting

Nursing Homes & SNFs

Eligibility and documentation control that stabilizes timing

SNF cash flow is exposed to eligibility volatility, documentation handoffs, and Medicaid timing risk. We install eligibility rigor, documentation checkpoints, queue discipline, and cadence that reduces retro gaps and stabilizes AR.

Request a Conversation Where revenue breaks KPIs
ControlsQueue disciplineEscalation pathwaysExecutive cadence
Eligibility rigorRetro gaps reduced
Documentation handoffBilling-ready packets
Medicaid timingVisibility and cadence
SNFs & Nursing Homes

Stabilize payer workflows and keep claims moving

We install controls and a weekly cadence so performance is repeatable across teams, payers, and locations — without heroics.

Discreet resolution capability: Recovery is handled via standardized documentation and payer-facing governance—kept subtle and compliant.

Where cash breaks

Typical failure modes we map in the first 10–14 days.

Signals

  • Managed care auths missing or late
  • Documentation gaps delaying billing
  • High denial rates with inconsistent resubmission
  • Medicaid workflows creating long aging tails
  • Write-offs rising without preventability tracking

Root causes

  • Missing controls (no owner, no cadence)
  • Work queues misaligned to payer rules
  • Documentation + coding handoffs inconsistent
  • Appeals built ad-hoc instead of industrialized

The operating model we install

A control system: dashboards → queues → escalation → weekly exec cadence.

Interventions

  • Intake/auth controls + documentation readiness checklist
  • Claims lifecycle playbook: edits → denials → resubmissions
  • AR ownership model with escalation and closure metrics
  • Preventability tracking for write-offs and recoveries

What you get

  • Playbooks, templates, and manager scorecards
  • Queue design + SLA definitions per workstream
  • Payer performance reporting and variance tracking
  • Weekly leadership readout (10-slide style)

KPIs leadership can run

We choose a tight set of measures that drive behavior and closure.

Billing lag (days)
↓
throughput up
Denial rate
↓
root causes closed
AR days
↓
faster close
Preventable write-offs
↓
governed
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