SMM is a code that stands for Service Media Market, which is the terminology used for the process of identifying and collecting all the bills and fees from different medical facilities across the country. The whole process is made possible through the provision of a computer system which is open to the public. The prices charged by different hospitals vary according to the services provided and the differences in the fees charged by different hospitals might even go up to five times.
In order to keep track of all these differences, the hospitals would like to keep their records in a single place which is located at different locations. Through this system, each facility, be it a hospital or an outpatient clinic, would be given a unique label and the payments, billed in a specific way, would be sent to them through a centralized system.
What makes this a complicated and a complex procedure is the fact that different states have different rules and regulations to follow. However, this is where the concept of a “smm panel” comes into play.
Every state has a department of insurance that is in charge of regulating the state SMM programs. These departments regulate how hospitals are supposed to function as well as the medical coding providers. It is their job to find out if any hospital is not complying with the guidelines set by them.
A panel is formed when one or more medical biller’s offices become dissatisfied with the services provided by a particular facility. This panel would then scrutinize the bills of these facilities in order to determine if the payments made were legitimate. If there is any discrepancy, they will report this to the supervising department of the department of insurance so that they can take action against the hospital.
They act as a mediator between the concerned parties and ensure that the panel is impartial. In other words, they would ensure that the client’s interests are safeguarded. After the panel has ascertained that the payments made are legally valid, they send the bills to the facility that is being questioned.
The facility then has to comply with the certain rules provided by the panel. Most importantly, the facilities should abide by the terms and conditions of the panel’s agreement. The top smm panel is not required to pay anything unless and until the panel finds that the bill was not paid legitimately.
All the reports prepared by the panel would be stored in the database of the SMM program. The database can be accessed by the hospitals who are unable to access it due to some technical reasons. This is done in order to keep a check on any kind of irregularities that might take place.
As mentioned above, not all the medical coding facilities can be located by a SMM panel. There is a list of approved facilities available online that a panel might go through and confirm that all the fees charged are genuine. These facilities are deemed to be legitimate and the fees charged are legal.
However, if a panel does not find any compliance to their rules, they might have to discontinue the entire service offered by SMM. However, in order to do this, a client would have to inform the facility to stop their service as well. If the complaint is found to be valid, the doctor’s office or medical provider can appeal to the panel so that the matter could be heard.
If the panel does not agree to its ruling, the doctor’s office or medical provider would have to close down their services. To help those who are in a hurry to learn more about what SMM is all about, I would recommend checking out my blog. Here, you will be able to learn about the system itself as well as how you can set one up yourself.