To become part of the SSS Recompression Chamber Network it is required that all affiliated hyperbaric companies have a rational bases for their billing rates.
While Rate Standardization is not universal for SSS Affiliates, it is very close. In some instances, because of deep under-utilization, some chamber may employ special fees to remain open.
Being a worldwide organization while at the same time adhering to first world standards of service, maintenance, education and training requires a set amount of capital expenditures. Recognizing also the fixed costs (regardless of volume) in maintaining a response-ready Medical/Technical Facility (in areas where this was either unknown, or very difficult to rely on) is a factor in rates.
To ensure that quality standards are maintained and available, and because recreational diving recompression facilities have a low patient turnover, recompression rates are set factoring all relevant overhead conditions. “Customary and reasonable” rates are set at a benchmark US$ or Euros per hour. The “reasonableness and customary” nature of such rate is something MHI helps to achieve through feedback, so long as SSS Guidelines and standards are met in the facility’s modus operandi.
Preferential Billing Rates
SSS Network members, through MHI, may negotiate preferential billing rates for underwriters who produce volume over time and/or who distinguish themselves with exemplary claims handling procedures.
There are some established preferential billing clients (assistance companies / insurers) who receive a direct benefit in the form of monetary savings from network members.
Medical Hyperbarics Inc. (MHI), is used by the SSS Recompression Chamber Network for insurance paper handling. It is in the business of processing medical claims for foreign (Non-US based) medical providers and offers its affiliates a vehicle to assign MHI the right to process their claims for a more standardized administration of claims.
Many chamber affiliates are inexperienced in the processing of such claims, focusing (as they ought to) in medical services – while MHI and its branch have extensive experience in administering and processing insurance claims. MHI thus establishes contracts with some of its affiliated hyperbaric chambers to endorse the acceptance of the claims (and undertake the collection obligations) from such Medical Services Providers – to become the claims processor. This assignment in the collection of claims is for specifically negotiated administrative fees.
All Hyperbaric affiliates who request this service would assign to MHI their interest in any claims that they may have. This assignment includes giving MHI the ability to file claims on behalf of the affiliate and its patients, pursue any necessary appeals on such claims, and when necessary, institute legal proceedings to ascertain rights under the contracted policies.
The responsibilities of the affiliated Hyperbaric Chamber will be to promptly assign such claims to MHI upon its receipt and shall further perform all acts and conditions that are necessary or requested by MHI to effect such assignment. The affiliated chamber in this case will expressly agree that MHI shall have the right to receive the assignment of such claims and to settle such claims for such amounts as it, in its discretion, may see fit.
MHI may also assist in the coordination of direct-pay patients when the circumstances so dictate.
For further information on preferential billing rates contact Medical Hyperbarics Inc. at firstname.lastname@example.org