Reimbursement Model for IndustrialOccupational Athletic Trainers

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Reimbursement Modelfor Industrial/OccupationalAt
hletic Trainers

• By
• The CIC Committee
• OATA with help from NATA

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Your Objective

• To receive reimbursement from industrial
  companies for services rendered to employees and
  other individuals (spouses, retirees,
  contractors, owners, etc) associated with the
  company.

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What You Will Need

• First and foremost a medical director
• An equipped AT room complete with office space
• Computer software and hardware systems to track
  patients, maintain clinical records, and to use
  for billing
• Billing staff and/or billing service
• Enough ATCs to cover all shifts at the company
• Policy and procedure manual, HIPAA/FERPA
  compliance manuals, current CPT Coding manual,
  ICD-9 manual
• Knowledge of BWC forms and procedure
• Good relationship with OSHA (Occupational Safety
  and Health Administration)

4
Your Education and Training Should Include

• NATABOC certification
• Business classes with financial terminology
• Learn financial formulas such as payback period,
  return on investment, cost avoidance, etc.
• Ergonomics
• BWC forms and procedures

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Possible Types of Services Provided

• Injury emergency first aid, injury treatment,
  rehabilitation, and injury prevention programs
• Ergonomics, job site/type evaluations
• Work conditioning, hardening
• Functional capacity evaluations, functional job
  descriptions
• Health promotion-general wellness and fitness
• Case management, counseling

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Your Contract Possibilities

• Flat Fee Model
• Pay per Service Model
• Profit Sharing Model

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Flat Fee Model

• The company pays you a set amount of money per
  month for athletic training servicesin essence
  you are salaried.
• You provide any and all AT services and billing
  then is done through the company physician for
  any injury services.

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Pay Per Service Model

• You set the fees for different types of services
• i.e. xx per modality, xx per educational
  programs provided, xx per ergonomic-related
  work, xx per patient treated, etc.
• Make sure these fees are all pre-determined and
  documented well
• Do weekly, monthly, and yearly summaries to
  demonstrate cost savings to the company
• Negotiate these fees yearly
• Be honest and efficient

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Profit Sharing Model

• Your salary is set at a pre-determined amount,
  but incentives are built into the contract
• I.E. You get xx per year plus 25 of health care
  cost savings to the company
• All incentives must be clearly specified upfront
• Keep accurate records and report weekly, monthly,
  and yearly on cost savings related to you doing
  your part

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Revenue Potential

• You must prove your worth to the company
• Establish yourself as the health care manager for
  all personnelthis is your team!
• Do your job well and the rewards can be great!

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Resources Available to You

• NATA Committee on Revenue (COR)
• Ken Kopke, ATCthe father of the Industrial
  Athletic Trainers (Hes in Michigan)
• Each companies yearly statistics on health care
  costs
• Medicares relative value scale-they keep
  accurate records of each providers billings and
  charges and then average them and all payors tend
  to follow these charges
• NATA web-members section info by committees

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Another Possibility For You?!