iata committee on revenue past reflections/future directions and how you can participate

IATA Committee on Revenue

Past Reflections/Future DirectionsAnd

How YOU Can Participate

Where do we start?

• March 2012 IATA COR Survey

– How members responded?– What is being done about it?

State/District/National levels– How does the Revenue/Reimbursement Binder

answer these questions?– What can you do?

Survey Responses

Specific Responses to the survey:

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• Companies don't want to risk not getting paid. They are not sure if they will get paid for an AT evaluation, so they stick with what they know will get reimbursed by the insurance companies.

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Specific Responses to the survey:

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• This is not something that can be resolved by a grass roots campaign, members pay good money to their professional organizations and these organizations should be using that money to hire the appropriate professionals to pursue AT reimbursement.

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Specific Responses to the survey:

• Make the IATA/NATA work for us.

Would the billing department be willing to share specific information regarding these cases?

Biggest Healthcare Insurance Companies

•Blue Cross Blue Shield•United Healthcare•Cigna•Aetna•Private Healthcare Systems

• Above insurance carriers are not recognizing athletic trainers as licensed healthcare providers. Many carriers, if asked why they don’t recognize ATs, will say they don’t have that information and will transfer the call to “higher ups.” Higher Ups may say they will forward the information on, and things get “lost.”

• The IATA /COR is still trying to learn/find the mechanism to “break down the walls” mentioned above.

• The IATA/COR is working with GLATA to assist with the above process.

• Some insurance carriers have asked for data regarding patient care efficiency of AT providing rehabilitation services.

• If data is provided, companies have said the data wasn’t “what they wanted,” but do not tell us exactly what they want. The COR has been trying to determine what data the carriers are looking for.

Who would be interested in a future meeting/webinar/conference call to discuss any COR items or reimbursement issues about any problems that you’ve had in your setting?

Have you downloaded/read any portion of the current reimbursement manual on the IATA web site?

ILLINOIS ATHLETIC TRAINERS’ ASSOCIATION

COMMITTEE ON REVENUE (COR)

Reimbursement/Revenue Binder

How to get to the IATA COR binder:

• Step 1- Go to the IATA web page: http://www.illinoisathletictrainers.org

Click on “IATA Committee Groups”

Click the hyperlink for “Committee on Revenue”

Click “COR Revenue/Reimbursement

Binder”

COR Binder Summary

Key AreasCOR Mission/Objectives – Pg 5High School Section – Pg 12Physician Extender Section – Pg 13NPI Sign Up Process Directions – Pg 19CPT Code Information – Appendix BIllinois AT Practice Act – Appendix AFAQ‘s– Appendix H

Steps YOU Can Take

• Become Familiar with the COR Binder• ALL AT’s Obtain their NPI• Pursue the Credentialing Process for Provider

Recognition (Use PT, then add note regarding lack of AT Identifier)

• Report Successes/Failures to the COR• Request AT Services be added to Employer

Provided Insurance Coverage

Steps YOU Can Take

• Communicate with your Legislators• Support your PAC’s financially (IATA, NATA)• Become an Educated Consumer/Provider• Think like a Business Owner• Don’t Let Others Dictate Our Abilities/Know

the Laws/Rules• Don’t expect others to fight our fight

COR Contact Information

Feel free to contact any COR member for further information or questions:

Mike “Sully” Sullivan, MS, ATC sullyatc@comcast.net

Ted Hirschfeld, MS, ATC, OTCtedatc@aol.com

Holly Odean-Carpenter, MS, ATC, CSCShodean@gmail.com

Mike Barnish, MS, ATC, CSCS barnish@att.net

Mark Rieger, MS, ATC, CSCS Mark.rieger@carle.com

Jeff Petersen, MBA, ATC, LNHA jwpetersen@att.net