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Premium member Presentation Transcript 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 Non-Athlete Outpatient PT Internal & External Non-Athlete Physician Extender Internal & External Facility Rental 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 University Personnel Student Body General Public Staff or Facility Driven What services are we going to bill? : What services are we going to bill? Every treatment session? Post-surgical cases? Time Loss? Every time the athlete walks through the door? Casting Aquatic Therapy Braces / Orthotics Wound Care Physician Services Others? What percentage of your student-athletes have primary insurance? : What percentage of your student-athletes have primary insurance? 25% 50% 75% 90% 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 Software/Hardware Fees/legal and other consultants Personnel Physical Therapist Physician 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 Costs 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 Physical Therapist Physician Advantages and Disadvantages Where does the money go? : Where does the money go? Formal contract Informal contract Revenue Distribution Service Driven vs. Profit Driven Who decides about implementing this process? : Who decides about implementing this process? University President Board of Regents Athletic Director Dean of Student Affairs Head Athletic Trainer Team Physician Health Services Director Legal Counsel Dean of Medical School Where is this program “Housed” : Where is this program “Housed” Internal Athletic Department Health Services Physical Therapy Department Medical School External Physician Group Private Group Advantages and Disadvantages Presentations to members : Presentations to members 2008 annual meeting District meetings 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 College/University Athletic Trainers' Committee Ron Courson, ATC, PT, NREMT-I Charles Thompson, MS, ATC Chair Chair-Elect 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 503) 768-7058 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 You do not have the permission to view this presentation. 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