Client: Willow Grove Care Center ((Name changed for confidentiality)
Facility Type: Skilled Nursing Facility (SNF), 120 beds
Location: Midwest, USA
Date: January 2025
The Problem
Too many billing errors. Too many delays. Too much pressure on staff.
In early 2025, Willow Grove Care Center started noticing serious issues with its billing process:
- 1 in 5 claims were getting denied
- Payments were taking 6+ weeks to come in
- Over $180,000 lost to billing denials last year
- Billing team couldn’t keep up with CMS rule changes
- Documentation often missed key details, leading to rejections
- Errors in PDPM coding, prior auth, and telehealth billing were piling up
As cash flow slowed, staff burnout increased. The leadership knew something had to change.
What They Needed
Willow Grove wasn’t looking for just another billing company. They needed a partner who could:
- Fix what was broken
- Help staff stay updated with Medicare and payer changes
- Reduce the time and effort it took to submit clean claims
- Handle rejections quickly and professionally
- Give their team breathing room to focus on patient care
The Rapid RCM Solution
Rapid RCM Solutions stepped in with a hands-on, practical strategy—no fluff, no complicated setup.
1. Smart Tech Integration
We connected their system directly to Willow Grove’s EHR. This allowed for:
- Real-time eligibility checks
- Automatic updates to PDPM and ICD codes
- Built-in modifier checks to prevent errors before submission
- No more guesswork or manual cross-checking.
2. Focused Training
Instead of overwhelming the staff with technical jargon, Rapid RCM provided:
- Monthly webinars tailored to SNF billing needs
- Short training videos for new updates (like the FY2025 Medicare rule changes)
- Step-by-step guides to help teams document correctly
- This helped boost team confidence without taking up too much time.
3. Strong Denial Management
We didn’t just wait for denials—we worked to prevent them:
- Analytics to catch repeat errors
- Automated alerts for missing documentation
- Fast appeal and resubmission process
In one case, a $28,000 Medicare claim was caught before submission because it lacked a physician recertification. Staff fixed it within two days, and the claim was paid in full—on time.
4. Easier Documentation
To help nurses and therapists, Rapid RCM introduced:
- Simple digital checklists
- Ready-to-use templates that matched payer rules
- Real-time feedback on what was missing in a chart
- No more scrambling when an audit hits.
Results After 6 Months
| Metric | Before Rapid RCM | After Rapid RCM |
| Claim Denial Rate | 20% | 7% |
| Avg. Days to Payment | 46 | 27 |
| Annual Denial Loss | $180,000 | $42,000 |
| Sraff Training Compliance | 52% | 98% |
That’s a 65% drop in denial rate and nearly $140,000 in recovered revenue.
What Changed for Willow Grove?
- Clean claims the first time
- Faster payments
- Less stress on staff
- Confidence in compliance
- More time for actual patient care
Final Thoughts
Skilled nursing billing isn’t getting any easier. If anything, it’s more complex than ever. New rules, tighter audits, and payer-specific quirks make it hard to keep up—especially for in-house teams stretched thin.
Willow Grove’s story shows what can happen when the right support is in place. With the right RCM partner, SNFs can stop firefighting and start improving.
Need Help with SNF Billing?
Rapid RCM Solutions helps skilled nursing facilities across the U.S. get paid faster, reduce rework, and stay fully compliant—without putting extra pressure on your team.
