Components & Challenges in Sports 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.
Our medical billers in Hawaii aim to provide you to the best Medical Billing services with maximum efficiency. For almost 10 years in the industry now many of them have been involved in all aspects of medical billing, coding, collections and compliance to HIPAA guidelines. Our billers are located in all the major cities like Honolulu, Hilo, Kailua, Kaneohe and Kapolei. Their skills across the following can help your practice to thrive:
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Patient demographics Entry
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Filing of Electronic claims
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Follow up on outstanding and denied claims
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Auditing Codes with ICD-9 and CPT
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Timely Payment posting
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Providing reports on a regular basis to show claims status
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.
