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Sports Medicine Billing Services California, CA

Components & Challenges inSports Medicine Billing

Sports medicine faces the same indifference from insurance authorities in the US as sports in general do from us: that they are important but not indispensible. This indifference has denied sports medicine the distinction of a specialty across the US.

Sports physicians aren’t educationally distinct from family physicians in a substantial way and a family physician can become a sports physician by applying for a dual credential with insurance authorities. However, when family physicians apply for dual credential, they are denied on the basis that family medical practice and sports medical practice are different disciplines and one can’t become the other or both.

To address these two challenges, now sports medicine is mostly practiced via managed care services to facilitate association with local insurance bodies to help reimbursement of claims. But, managed care service involves assigning a physician to each care recipient, making it necessary, for successful reimbursement, to establish that a treatment was carried out upon the referral of the assigned physician. It also necessitates accurate documentation of all medical and nonmedical details required and familiarity of care providers with resulting complexities of managed care services.

Running a medical practice in California can be quite challenging when it comes to medical billing and coding. Our billers and coders in all the major cities of California including Los Angeles, San Diego, San Jose, San Francisco, Fresno can help you settle your requirements here are some of the services which our expert medical billers and coders specializes in:

  • Tracking and follow-up on unpaid claims
  • Preparing Patient statements and payment posting
  • Customizing billing reports for better control
  • Primary and secondary insurance claims filing

Value Our California Billers Bring:

Our medical billers and coders are not limited to just the big cities such as Fresno, San Francisco, and San Diego but also all other smaller cities and towns in California. Moreover our billers are compliant with HIPAA guidelines and are updated with all industry updates through medicalbillerandcoder.com. This makes sure that your practice is run in the most efficient and legally safe conditions. Our Billing specialists also ensure that your patients are hassle free and their billing queries are answered well.

The expertise of our billers is vast and includes but is not limited to Past Due Collections, Electronic Medical claim filing, Medicare Audit Protection, coding and diagnosis analysis for maximum allowable reimbursement, customized accounts receivable and revenue cycle financial analysis, electronic claims submissions, denials management and payment posting, dedicated and relentless insurance follow-up, patient statements and patient-centric support, provider enrollment support, and standardized reporting.

Our Specialties:

Our medical billing specialists are committed to improving your productivity by utilizing finest processes and health care information technology such as Electronic Medical Records. These medical billers and coders maximize your revenue, ensure timely compensation, and offer medical billing and coding services in specialties including Family Practice, mental health , pain management, Physical Therapy, radiology, Internal Medicine, neurology, orthopedic, and numerous other areas.

Our Software Experience:

The fact that physician shortage is set to quadruple in the next decade according to AAMC (Association of American Medical Colleges) makes it vital that physicians utilize professional and accurate medical billing and coding services. The various software that we provide in addition to the value added services mentioned above ensures that physicians are capable of keeping up-to-date with the healthcare IT sector reforms and improvements. Some of the medical coding and billing software that our billers have experience on include Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity, and Altapoint.

Difficulties & Challenges California physicians Face:

The most common challenges faced by physicians in big cities such as San Jose and Los Angeles are underperforming accounts receivables or collections and claims denial. Both these situations along with other errors may lead to decreased revenue. Our billers provide the solutions to these problems by making the denial management efficient and offering services such as integrated medical billing with EMR along with numerous other value added services like sending patient statements and processing refunds to Medicare in order to preserve your practice from RAC audits.

As a physician in California, it becomes difficult to keep track of all the changes taking place in the legislation related to your practice. This is where the expertise and experience of our medical billing specialists can be of immense help. It almost seems that payers are in the business of claim denial and can afford to make mistakes at your expense. Although the new HIPAA guidelines would ensure a smoother process, the amount of patient-doctor encounters would increase in the future making it difficult to extract time for coding, billing, claim denial and compliance with HIPAA regulations. Specialized medical billers and coders such as ours can ensure that your practice not only flourishes but is also HIPAA compliant.

In addition to the above hurdles, sports medicine reimbursement is also subject to all the insurance regulations that apply to other specialties. This causes care providers involved in sports medicine left to negotiate with mounting ARs and losses. Care providers are not in a position to handle this effectively as it requires handling intricate medical and regulatory details, filing claims and following them up for timely reimbursements – things that are outside their area of competency and can be best dealt with if left to experienced billing and coding houses.

Outsourcing to MBC:

MBC, the largest billing and coding consortium in the US, has helped care providers involved in sports medicine reduce their mounting account receivables through accurate handling of details, submission and rigorous follow-ups with insurance officials, ensuring timely reimbursements. MBC’s billing and coding professionals are not just familiar with intricacies of regulatory and medical details but also have sound knowledge of state-specific exceptions which helps them account for the fact that few regulations to an extent may not be uniform across all 50 states of the US.

Our flexible billing and coding service models ensure that they can be adopted by any care provider regardless of size, scale and nature of operations:

Through our Revenue Management Consulting (RCM) service model we can prune your in-house operations stripping out dated and time-consuming procedures and software applications and guide in replacing them with ones that will help you handle the entire billing and coding process with ease and ensure compliance.

However, if you are an independent sports physician and think a setup will only restrict your mobility and access and bring down the fluidity of your operations or you just don’t need in-house billers and coders, our outsourced billing and coding services will work well for you, where you will be able to completely ship out billing and coding responsibilities to us and solely concentrate on your practice as we help you to keep up the inflow of your revenues.

With a network spanning across 50 states in the US, we have helped countless care providers to improve their profitability through accurate preparation, submission and timely reimbursement of claims.