SERVICES WE OFFER
Guidelines and Processes
One of the driving barriers preventing colleges and universities from establishing an athletic healthcare billing system is lack of guidelines and processes.
Leveraging our knowledge of industry standards and competitive best practices, we work with the university’s team physician to establish the following:
» List of Eligible Treatments and Rehabilitation Parameters
» Utilization and Placement of the National Provider Identifier (NPI)
» Diagnostic and Procedural Billing & Receivable Codes
» Policies In Line With Institutional Guidelines
REV-Athletics is experienced in establishing unique billing codes and structures for each of our institutional partners.
Claims and Insurance Negotiations
In the insurance claim billing environment, our firm is equipped to not only process the claim request but also negotiate with insurance companies if a claim is denied.
Claim Initiation
Process begins with submission of the claim for the maximum allowable amount determined by set industry standards. We credential the provider groups as a willing network provider recognized by the top five national insurance companies, including Aetna Inc., Anthem Inc., Cigna Corp., UnitedHealth Group, and Humana Inc.
Appeals
If the claim is denied, or falls below the maximum allowable amount, REV-Athletics will review the denial reason and appeal the claim. Leveraging our industry knowledge our appeal will include legal citation, insurance industry standards and past precedents.
Although we partner closely with the athletic department, REV-Athletics is responsible for the manpower to initiate and appeal all insurance claims.
HIPAA, HITECH and Regulation Compliance
REV-Athletics will provide and maintain signed consent forms for all of your student athletes. The form authorizes the release of medical information as well as access to the student’s Electronic Medical Records (EMR) to obtain athletic trainer treatment information to submit to private insurers for claims.
The consent form is updated annually and complies with HIPAA, HITECH and applicable laws ensuring protection of electronic and physical personal health information.