Sports Medicine Billing Services

Getting Started

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.