College/University Billing Model : College/University Billing Model 2008 Web version A survey done by the Collegiate Sports Medicine Foundation asked the question: Do you bill for AT Services from the athletic training room? : A survey done by the Collegiate Sports Medicine Foundation asked the question: Do you bill for AT Services from the athletic training room? 12% responded that they were billing, 68% were not billing and 20% were considering billing in the future.
Philosophy was the number one reason for not billing.
University Administration was cited as the biggest obstacle to billing. Resources available on the NATA website : Resources available on the NATA website How is billing in the collegiate setting different from billing in a clinical setting? : How is billing in the collegiate setting different from billing in a clinical setting? Types of Business Models used in Athletic Training Departments : Types of Business Models used in Athletic Training Departments Outpatient AT
Internal & External
Internal & External
Ancillary Services Models in Practice : Models in Practice Questions to Consider : Questions to Consider To bill or not to bill.
Research to undertake before making the decision to bill Are there restrictions in my state that make billing for service unfeasible? : Are there restrictions in my state that make billing for service unfeasible? Are you familiar with your practice act?
Are you familiar with the practice acts of other professionals providing services in your facility?
Are you familiar with state laws governing businesses and healthcare providers?
STARK, Anti trust, HIPAA Philosophically should we bill student-athletes for services we have traditionally provided for free? : Philosophically should we bill student-athletes for services we have traditionally provided for free? Service Driven vs. Profit Driven What is our patient population? : What is our patient population? Student Athletes
Athletic Department Staff
Staff or Facility Driven What services are we going to bill? : What services are we going to bill? Every treatment session?
Every time the athlete walks through the door?
Braces / Orthotics
Others? What percentage of your student-athletes have primary insurance? : What percentage of your student-athletes have primary insurance? 25%
100% How are we going to address co-pays, deductibles and remaining balances? : How are we going to address co-pays, deductibles and remaining balances? Student-Athlete Pay?
If not then who?
Can we “Write Off” co-pays?
Account for it someway! Will billing for services impact our secondary / excess insurance? : Will billing for services impact our secondary / excess insurance? Yes, and it actually could decrease your secondary premium.
Yes, depending on how co-pays and deductibles are handled.
Yes, percentage of student athletes without insurance. How much are we going to spend to start the process? : How much are we going to spend to start the process? Clerical
Fees/legal and other consultants
Additional Athletic Trainers
Other? Who is going to do the billing and collection? Create your team of experts : Who is going to do the billing and collection? Create your team of experts Current Athletic Training Staff
New Athletic Training Staff
Clerical / Insurance Coordinator
Billing Service (outsourcing)
Legal advisors Hiring a billing service : Hiring a billing service Areas of consideration in contractual relationship
Staff availability and expertise
Software: purchase, support, upgrades and maintenance
Expertise: Type of billing, coding, regulations, provider contracts and documentation
Percentage of collections
Per Claim Services Provided by a Billing Service : Services Provided by a Billing Service Train college/university staff on procedures.
Set up and manage software.
Allocate funds for accurate financial reporting.
Advice on coding.
The billing service is experienced and trained to bill for medical services.
Establish a contractual relationship with the provider to ensure procedures and compliance are being followed.
Monitor financial reports and inform of red flags Who is the Billing Provider? : Who is the Billing Provider? Athletic Trainer
Advantages and Disadvantages Where does the money go? : Where does the money go? Formal contract
Service Driven vs. Profit Driven Who decides about implementing this process? : Who decides about implementing this process? University President
Board of Regents
Dean of Student Affairs
Head Athletic Trainer
Health Services Director
Dean of Medical School Where is this program “Housed” : Where is this program “Housed” Internal
Physical Therapy Department
Advantages and Disadvantages Presentations to members : Presentations to members 2008 annual meeting
2009 annual meeting
This is still being decided, if you would like a presentation made at your state or district meeting please contact your district CUATC member. CUATC Contacts : CUATC Contacts National Athletic Trainers Association CUATC
Ron Courson, ATC, PT, NREMT-I Charles Thompson, MS, ATC
University of Georgia Princeton University
PO Box 1472 Caldwell Field House
Athletic Association Faculty Rd
Athens, GA 30603-1472 Princeton, NJ 08544-0001
Phone: (706) 542-9060 Phone: (609) 258-3527
FAX( 706) 542-9061 FAX(609) 258-7045
Robert J. Casmus, MS, ATC, LAT Randall Cohen, ATC, PT
District 03 District 07
Catawba College University of Arizona
2300 W Innes St Athletic Training
Athletics Department McKale Memorial Ctr N 108
Salisbury, NC 28144-2488 Tucson, AZ 85721-0096
Phone: (704) 637-4350 Phone: (520) 621-0820
704) 637-4799 FAX(520) 621-8771
John Faulstick, ATC, LAT William McDonald, MA, ATC
District 04 District 09
Kent State University Director of Sports Medicine
Dix Stadium University of Alabama
PO Box 5190 12289 Lester Taylor Rd
Kent, OH 44242-0001 Northport, AL 35475-2721
Phone: (330) 672-2786 Phone: (205) 348-2988
FAX: (330) 672-5520 FAX (205) 348-9932 Mark L. Pietrok, MEd, ATC Arthur Poitras, ATC
District 10 District 01
Lewis & Clark College-Athletic UMASS
Dept 1 University Ave
11149 SW Matzen Dr Lowell, MA 01854-2827
Wilsonville, OR 97070-8574 Phone: (978) 934-2321
Phone: (503) 768-7065 FAX: (978) 934-2058
Rex Sharp, MS, ATC Nancy Smith, MSEd, ATC
District 05 District 08
Head Athletic Trainer Sierra College
Univ of Missouri-Columbia 403 Keehner Ave
Department of Athletics Roseville, CA 95678-4045
Columbia, MO 65211-0001 Phone: (916)781-0486
Phone: (573) 882-2375
FAX: (573) 884-0692
Charles Thompson, MS, ATC David Weir, ATC, LAT
District 02 District 06
Princeton University Texas A&M University
Caldwell Field House PO Box 30017
Faculty Rd College Station, TX 77842- 3017
Princeton, NJ 08544-0001 Phone: (979) 458-3662 Phone: (609) 258-3527 FAX: (979) 847-8514
FAX(609) 258-7045 NATA staff contact for revenue: Patty Ellis firstname.lastname@example.org 972-532-8833