Athletic Department Solutions
PPE Reimbursement
PPE Reimbursement Program
Athletic Department Solutions (ADS) has developed a streamlined process to generate revenue to the sports medicine / athletic department for doing nothing different than you’ve done for years. Due to healthcare reform and enhancements in technology, we are able to obtain reimbursement from student athlete individual
health insurance companies for physicals performed by your team physicians.
Major BCS schools, community colleges and even high schools are able to participate in this program.
For students with valid health insurance, we are able to collect $200 - $350 per physical (depending on components of physical).
Do the math:
400 Student Athletes of which 50% would be able to obtain reimbursement = 200 Eligible Student Athletes
200 Student Athletes X $250 (Average Reimbursement Rate) = $50,000
Fee for Organization, Set-up, Billing and Collections = 25% = $12,500
Net Revenue to Sports Medicine Department = $37,500
How It Works
1. ADS loads all student-athletes into a national database. This enables us to verify health insurance coverage, including deductible, co-insurance, etc.
2. ADS provides a master implementation program that registers the school, provider and insurance carriers.
3. School provides ADS with student athlete demographics, insurance information and a copy of the signed and complete physical form. (Note: Doesn’t all have to be at the same time)
4. ADS will verify all primary health insurance and provide report back to school.
5. ADS will bill for physicals for those with valid health insurance.
6. When checks are received, ADS will reconcile accounts and provide checks to school contact for deposit. (Note: checks will be made out to the billing entity, school)
7. At the conclusion of the month, school would be invoiced 25% for only those checks that were received.
8. When primary insurance doesn’t pay, ADS will work to obtain maximum reimbursement with the insurance
company, however no bills for non-payment will go to the studentathlete, their parent or the school.
Common Questions
1. Do we need to pay our physicians?
Completely up to the school and the physician
2. Is there any up front fee?
No; the set-up fee of $3000 is only collected after you receive the first $3000 in insurance checks.
3. Do we have increased liability?
No; the liability exists in the service provided, not the fact that you bill for the service.
4. Will student athletes or parents receive a bill if insurance doesn’t pay?
No; they will receive an EOB (Explanation of Benefits) from their insurance but no bill will be generated for unreimbursed services.
5. Can we bill for physicals that have already been completed?
Yes, but those performed in the last 30 days have the highest reimbursement rate but we can bill up to 12 months.
6. We have both a internist and orthopaedic provide the physical, can we bill for both?
Yes, provided that the exams are on two separate forms. Ortho screening by a orthopaedic typically billed at an additional $120.
7. What happens if we don’t get any insurance checks, is there a penalty?
No, we only collect when you receive insurance checks. No risk to the school and in fact the school would receive a scanner and verification of insurance coverage on all student athletes
regardless of reimbursement.
If you are interested in learning more about this program please submit your information below.
Name:
School / Organization
State:
Phone:
Email:
