How Does The Fitness Industry Can Comply With Medical Billing Industry?
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How Does The Fitness Industry Can Comply With Medical Billing Industry?

How Does The Fitness Industry Can Comply With Medical Billing Industry?

The US population is deviating towards the fitness industry with a highly concentrative concern. As, there are so many problems arising due to the passive lifestyle and increasing obesity issues. It is putting a lot of burden upon the fitness industry owners to manage the massive data and accountability process.

People are rushing towards the fitness industry to have an organic solution to their ailments instead of depending only upon the medication and allopathic treatment. Therefore, physicians are also taking interest to suggest their patients appropriate physical exercises that are suitable to their health condition to make an active improvement in their physical and mental health condition. They are trying to assure the best fitness services for their patients and for this purpose, they will approach such fitness centers that are trust-worthy, provide relevant services and working under the laws and regulations of HIPAA.

Medical billing and coding specialists help the fitness industry to manage their financial services according to the rules laid out by HIPAA. They can officially manage their payment collection under the Government laws, along with this they can also manage their finance solely that provides them the benefit from both ends.

Physicians can prescribe their patients to lose weight, improve their cardiac functioning or do some physical exercise and this prescription would be written in their medical claim. Medical billers and coders will generate the claims and submit to the payers or the health insurance companies, which will help the fitness industry to receive payments from third party or secondary party payers as well. Thus, it will increase the number of income sources for the fitness industry, and generate more productive leads for them.

The health care provider would claim their services from health insurance companies by providing them the following information via medical billing and coding professionals;

  1. Diagnosis:

Physicians will execute the verification procedures for the diagnosis of the ailment. It will also involve the use of equipment, products, service staff and time. They will record the information and save them for the treatment purpose. The charges of these services would be included in the claim.

  1. Referral codes:

Referral codes contain all of the information of the patient’s visit. Therefore, the physician’s services received including; treatment, check-up, the equipment and products and physician’s suggestion (although it is related to diet, physical exercise etc.) are recorded and kept in referral codes.

  1. Patient’s insurance plan number:

Patient’s insurance plan number describes the location where the termination of the claim submission process occurs. So when the claim is submitted against the specific insurance plan number of the patient, then his/her all of the information would be forwarded to Health Insurance Company. So, if the physician has suggested the patient to receive fitness services from any gym or spa center then it would also be included in the payables of Health Insurance Company. The patient will co-pay the charges of the gym or any other fitness rehabilitation faculty from health insurance companies.

Compliance with the Government laws

By considering the importance of the fitness industry association with health care industry, the US Government defined some laws in HIPAA act 1996 for the fitness industry, if the fitness industry want their customers to co-pay with the involvement of third party or secondary party payers, then they also need to comply with medical billing and coding industry, as they will execute the claim submission process and ensure reimbursement by following the standard of codes defined by HIPAA act.

Therefore, for if the fitness business collaborate with the health care industry then, they are acquired to hire medical billers and coders. It is also convenient for the customers to co-pay the charges of health care facility and their gyms simultaneously with the involvement of third party payers or health insurance companies. This will also provide the fitness industry the benefit of both worlds. This idea is technically more appealing to business owners than any other business model.

The collaboration of the health care industry and the fitness industry can also help the fitness trainers to provide such services, products and training to their customers that rare suitable to their age, physical and mental health condition and the charges they can afford.

Therefore, if any fitness center (including; gyms, massage therapies and supplement providers) would build a relationship then they also have to consider medical billing and coding services to build a proper hybrid model for their business.

Medical billing and coding services would provide the following benefits to the fitness industry;

Ancillary Health Services:

The fitness trainers can also become the health mentors for their customers by providing them; weight-loss supplements, weight-loss counseling, behavioral health programs, chiropractic care, lab testing and urgent care services. It will lead the patients to conveniently co-pay charges of the fitness center via a health care insurance plan. Medical billers and coders would generate a claim and submit to the secondary or third-party payers and ensure reimbursement.

Out-patient physical rehabilitation services:

According to a recent survey; the fitness industry alone contributes the third-quarter part in the annual income of the United States of America as the total revenue generated by this industry is estimated up to $30 billion. As people are demanding a greater number of fitness rehabilitation centers instead of physician’s services. As these fitness services can help patients to recover their areas of speech, neurology and they can also provide sports-related support to their members with appropriate guidance of physical exercise.

Therapeutic and health benefits:

Health mentors validate and endorse their patients to have therapeutic and health benefits of massage. This aspect has uplifted the demand of the fitness industry, by patients as well as physicians. They also want to comply for these services with the fitness industry for better cure of their patients. The massage centers alone contribute 20% of the annual GDP of the United States of America.  Still there are more chances of the growth of this industry because of the increasing demand. Therefore, the fitness industry needs to comply with medical billing and coding industry to manage the co-pays, payables and other administrative tasks of these industries.

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