Sports Medicine Broadcast

Sports Medicine Broadcast

Third Party Billing – 581

September 13, 2019

What is Third Party Billing?

Third Party Billing means a patient comes in to see the AT and the AT sends the bill for payment to the insurance company. It does not mean you are working at a clinic and being paid hourly by the general fund, but you are billing for services as a PT or DC would.

Who is Joe Greene?

Started at the University of Wisconsin Hospital in 1991

Through various roles at the hospital, he was able to quickly move into an administrative role. Coupled with his state leadership roles, He was really able to look at Third Party Billing a make an impact.

2001 Implemented Autonomous Billing in Wisconsin

What is Orthovise?

The company Joe started to work with physicians and continue growing the autonomous billing aspect of Athletic Training.

2016 NATA issued an RFP pilot project to Joe Green and his team as the pioneer in 3rd party billing

What are the goals of the third party reimbursement project?

Ensure ATs receive reimbursement by insurance companies consistent with other allied healthcare providers. If a PT does manual therapy billed at $60/hour, then the AT acting within their scope doing the same task can be reimbursed at $60/hour.

Secure Consistent recognition of Athletic Trainers as allied health care professionals

What has the pilot study revealed?

* When ATs bill according to the policy they are reimbursed at a consistent level* There are some gaps in analysis* Are AT as cost-effective?

What Education is going on with this?

Payor (consumer) and Employers (hospitals/physician) are both needing education

ATs need to be able to bill correctly using the correct codes

Third Party Billing Resources from Joe

Check out for a growing list of resources but here are a few:

2019 Fall Symposium FlyerDownload

NATA News October 2018 NATA TPRI UpdateDownload

Billing and Reimbursement GuidanceDownload

Third Party Billing – Joe GreeneThird Party Billing – Joe GreenePosted by Sports Medicine Broadcast on Tuesday, June 25, 2019

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