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Facility Billing Services

Medical Billing for Intermediate Care Facilities (ICF/DD)

Intermediate care facilities for the developmentally disabled (ICF/DD) bill under long-term care rules that separate per-diem room-and-board from covered medical services, each with its own documentation and eligibility requirements. Quantix Health supports Southern California ICF/DD facilities with clean Medi-Cal LTC claims, share-of-cost reconciliation, and level-of-care records that hold up on review.

  • Medi-Cal long-term care and per-diem claim submission
  • Share-of-cost tracking and monthly reconciliation
  • Level-of-care and eligibility documentation support
Why intermediate care facilities (ICF/DD) choose us

Specialty expertise, not generic billing

Level-of-care documentation

We help align physician orders, plans of care, and level-of-care records with the ICF/DD subtype billed, reducing denials tied to missing or mismatched authorization.

Per-diem vs. medical services

We separate room-and-board per-diem from distinct medical and ancillary services so each is claimed correctly and not bundled or double-billed.

Share-of-cost reconciliation

We track resident share-of-cost obligations against monthly Medi-Cal claims and reconcile balances so the facility collects what it is owed.

Eligibility and LTC status

We verify Medi-Cal LTC eligibility, retroactive coverage, and patient status changes to keep admissions, discharges, and bed-hold days billing accurately.

Common billing challenges

Where intermediate care facilities (ICF/DD) lose revenue

These are the specialty-specific leaks we watch for — and fix at the root.

  • Share-of-cost amounts change with resident income or eligibility, leaving monthly claims under- or over-collected when not reconciled promptly.
  • Level-of-care documentation gaps between physician orders and the ICF/DD subtype billed trigger authorization and payment denials.
  • Bed-hold, leave-of-absence, and hospital transfer days follow specific Medi-Cal rules that are easy to miscount on a per-diem claim.
  • Retroactive Medi-Cal eligibility and pending applications create timing mismatches between admission dates and billable coverage.
  • Separating covered medical and ancillary services from room-and-board per-diem is error-prone and invites bundling denials.
  • Annual level-of-care redeterminations and continued-stay reviews lapse without a tracked recertification calendar.
FAQ

Common questions

How is ICF/DD billing different from standard outpatient billing?

ICF/DD billing runs on long-term care rules: a per-diem room-and-board rate, resident share-of-cost, and level-of-care authorization, with covered medical and ancillary services claimed separately. The eligibility and documentation requirements are distinct from fee-for-service outpatient claims.

How do you handle share-of-cost on Medi-Cal LTC claims?

We track each resident's monthly share-of-cost obligation, apply it correctly against the claim, and reconcile collected versus billed amounts so balances do not silently accumulate. Amounts are re-verified when income or eligibility changes.

Can you help with level-of-care documentation and recertifications?

Yes. We help align physician orders, plans of care, and level-of-care records with the subtype billed and maintain a calendar for continued-stay reviews and redeterminations so authorizations do not lapse. We advise operationally and recommend verifying current DHCS guidance.

Let's strengthen your intermediate care facilities revenue

Book a free, no-obligation consultation. We'll review your billing and show you the opportunity — no pressure.