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 Illinois billers are specialized in accurate and timely filing of your claims and provide full practice management for your medical billing needs.
Our billers across Illinois in Chicago, Aurora, Rockford, Joliet and Naperville specialize in generating claims, updating payments made, analyzing pending claims and expert follow up on patient outstanding.
You can judge the level of servicing required for your clinic’s requirement by experiencing the services they provide in:
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Patient demographics
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Credentialing of physicians
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Follow up on claims and tracking
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Verification on insurance benefits for patients
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Pre-authorizations and Pre-certifications
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Insurance claims processing
Comprehensive Medical Billing Services in Illinois
Our Illinois billers are experts in accurate and timely claims filing, offering comprehensive solutions tailored to your medical billing needs. We are located across major cities like Chicago, Aurora, Rockford, Joliet, and Naperville, and specialize in:
- Generating claims
- Updating payments
- Analyzing pending claims
- Patient demographics management
- Physician credentialing
- Claims tracking and insurance verification
- Pre-authorizations and pre-certifications
- Claims processing
Illinois Medical Coding Experts Boost Revenue & Financial Growth
With extensive experience in Illinois Medicare and BCBS, our billers understand state-specific denial reasons and negotiate better rates for physicians. Our proficiency in accurate coding, detailed code audits, timely insurance follow-ups, and accounts receivable management ensures higher profitability.
Additionally, our billers stay updated with the latest regulatory changes, ensuring your practice remains compliant and efficient. By leveraging our software certifications and expertise, we help optimize your revenue cycle and ensure steady growth for your practice while supporting federal efforts to reduce healthcare costs.
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.
