Many providers utilize various management services agreement offerings (MSAs) to help support their workman’s compensation patient segment.

These MSAs provide ancillary revenue for targeted DME support services while enhancing the treatment regimen and recovery process for the injured worker.

Although many physician practices own an internal DME ancillary service, and funnel most products through that division, several devices and services do not have assigned HFCA codes and need to be billed using miscellaneous codes for reimbursement. 

This often requires additional legwork and challenges during the pre-authorization process. 

In addition, TPCs traditionally contract with many insurance companies, making it even more difficult to navigate the authorization process.

As such, most MSA agreements aligned to the WC patient population leverage a third party to bill for these products under their tax ID.

This removes the burden and challenges for the practice, while creating a vehicle to secure profit for each referral. 

Although Stark Laws restrict these types of arrangements under Federal and commercial offerings, no such oversight exists within the WC space, as long as the parameters of the arrangement are spelled out in the agreement.

Most agreements charge a management fees of around 40% after COGS are removed, which are usually inflated, leaving a small profit margin for the provider. 

Plus, the physician has no control over what is actually billed to the WC carrier, which could jeopardize the referring relationship.

A better option is to bring the service offering in house, using alternative products that are equally comparable yet accessible. 

You can still leverage MSA options, utilizing a company to secure the pre-authorizations on your behalf, bill under your tax ID, and manage product delivery and patient support.

But now, you control the billed value and increase your profitability while providing a more compliant model that meshes with your other existing ancillary divisions.

AMG can offer solutions and comparison ROI’s to show how much more you can make while enhancing the quality of care to your patients.  Contact us for your free assessment.