Designing a Professional Services Billing Process for Brooke Army Medical Center's Trauma Surgeons

摘要

The U.S. Congress has obligated Brooke Army Medical Center (BAMC), Fort Sam, Houston, Texas, to seek the potentially significant reimbursement from health insurance providers for the care delivered to the large number of civilian trauma patients it serves. This study proposed that an achievable, seamless, efficient, and effective design could be identified to reimburse BAMC for the professional services of its trauma surgeons. The study also proposed that no legal barriers (i.e., statutory, regulatory, or judicial) existed to prevent the implementation of an itemized billing process to obtain third-party reimbursement for the professional inpatient services of BAMC's trauma surgeons. A case study methodology was utilized to perform a study of BAMC' s revenue cycle. The first proposition was partially supported by the study, while the second proposal was not supported. The TRICARE Management Activity will need to provide authorization for Military Treatment Facilities (MTFs) to begin performing itemized billing for inpatient services.