In 2011, the Indiana Legislature passed Indiana House Bill No. 1467 which allows for athletic trainers to receive reimbursement from third party payers for services that those payers typically reimburse.
Daviess Community Hospital has recently been designated as one of five pilot sites for the state of Indiana. All sites were chosen for various reasons. DCH stood out as a hospital setting, and billing for athletic training services is new to this facility. Others in the program include Community Hospital (Munster), Indiana State University (Terre Haute), Methodist Sports Medicine (Indianapolis), and St. Vincent Sports Performance (Indianapolis).
Those who are not familiar with rehabilitation therapy may not realize that until this bill passed, insurance companies did not reimburse facilities for care given by a certified athletic trainer.
Rick Shaw, MS, LAT, ATC, is the Indiana State Business Development Coordinator who has been instrumental in guiding the pilot project. Shaw said, “The goal of this pilot project is to develop and implement strategies for successful reimbursement of services listed in insurers’ benefit plans when services are provided by athletic trainers.”
As a participant, Daviess Community Hospital athletic trainers bill for their services under specific “codes.” Each insurance carrier is to recognize these codes and process claims. If claims are denied, it is Shaw’s team who works with the insurers to rectify the situation and pay the claim appropriately.
“At this point, we see very little issue with the exception of an occasional paperwork error,” said Shaw.
Per Shaw, the pilot is a collaboration between the National Athletic Trainers’ Association and individual states. The National Athletic Trainers’ Association chose to focus on states that have practice acts which are non-restrictive to reimbursement and strong member support for reimbursement. Indiana, along with Ohio and Wisconsin, are the only three states participating at this time. The program is scheduled to run until October 2017.
A few facts about athletic trainers:
– Athletic trainers are health care professionals who collaborate with physicians to optimize patient and client activity and participation in athletics, work and life.
– The practice of athletic training encompasses the prevention, examination and diagnosis, treatment, and rehabilitation of emergent, acute, subacute, and chronic neuro-musculoskeletal conditions and certain medical conditions in order to minimize subsequent impairments, functional limitations, disability, and societal limitations.
– Services are provided primarily in an outpatient therapy clinic.
Scott Sell, MS, ATC, director of Athletic Training Services at Daviess Community Hospital said, “I am honored that the state of Indiana and Indiana Athletic Trainers Association chose DCH to be a pilot site. This is a great opportunity for athletic trainers to be recognized alongside their physical and occupational therapy colleagues. The support of our CEO, David Bixler, and the entire DCH organization continues to be vital to the program. Special thanks to Clark Simpson, Rick Shaw, Joe Greene, and all the other athletic trainers who made this a possibility. This is a great step forward in recognizing the value of athletic trainers, and I look forward to the continued success of our profession.”