Revenue and Reimbursement Survey
Is your university billing for services provided in the athletic training room?
Information gained form this survey will only be reported in aggregate form.  No names or institutional names will be reported.  We thank you for your participation in this survey as we will post results after 50 schools have participated in the data collection.  We look to use this information to further understand what is taking place in college and university athletic training rooms regarding billing for services.
School:
Conference:
Classification:
State:
Contact Number:
e-mail Address:
Name:
Part A (No Responses):
What is the MAIN reason for not billing for services provided in the athletic training room?
What is the main obstacle in not billing for service provided in the athletic training room?
Part B (No - But Considering It Responses):
What services would you intend on billing for?
Number of Full-Time Staff
Although not the main reason, these are additional reasons why we would not bill for service in the athletic training room?  (Click only those that apply).
Thank-you and Proceed to Bottom to Submit
Who is the main supporter / promoter of billing for services in the athletic training room?
Who is the main obstacle of billing for services in the athletic training room?
How would you intend on being the service provider?
How many surgeries does your school incur in a year?
How much income would you anticipate receiving?
We would plan on billing for service from the following individuals?
Click on the following that are concerns / questions / obstacles in starting a revenue / reimbursement model?
We would like assistance in establishing a revenue and reimbursement model?
Please Proceed to bottom to submit survey.
Please Proceed to Part A
Please Proceed to Part B
Please Proceed to Part C
Part C (Yes Responses):
How many years has your university been billing for services provided in the athletic training room?
Which of the following populations do you bill for services?
Who is the service provider?
What services do you bill for?
How many surgeries does your school incur in a year?
How much money do you anticipate generating annually?
Do you have an administrative assistant that is responsible for the billing and collections process?
What percentage of the revenue generated goes into the sports medicine budget?
What type of impact has a revenue generating model made to your ability to improve the health care available to your student-athletes?
If you were to go to another university, would you begin a revenue / reimbursement model?
Do you think the reimbursement process will improve in the next three years?
Explain:
Yes
No
No - But Considering It
Philosophy
Additional paperwork
No need for additional revenue
State licensure
Administrative support
Understanding of process
Clerical support
Revenue generated would not go to sports medicine needs.
Not enough student athletes with primary insurance.
Other:
Philosophy
Additional paperwork
No need for additional revenue
State licensure
Administrative support
Understanding the process
Clerical support
Revenue generated would not go to sports medicine needs
Not enough student athletes with primary insurance.
Other:
Other:
Philosophy
Additional paperwork
No need for additional revenue
State licensure
Administrative support
Understanding of process
Clerical support
Revenue generated would not go to sports medicine needs.
Not enough student athletes with primary insurance.
Other:
University Administration
Athletic Department Administration
Team Physician
Athletic Training Staff
Self
Legal Counsel
University Administration
Athletic Department Administration
Team Physician
Athletic Training Staff
Self
Legal Counsel
Rehab. Post-surgical
Rehab. Time Loss (Including Surgical)
Physician Services (Office Visits)
Ancillary Services (Casting, Bracing, Wound Care, Orthotics, Etc.,)
Athletic Trainer
Physical Therapist
Physician (Physician Extender / Incident to Model)
0 - 56 - 1011 - 1516 - 2021 - 2526 - 3031 - 4041 - 5051 - 6061 - 7575+
$1 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - $75,000
$75,001 - $100,000
$100,001 - $150,000
$150,001 - $200,000
$200,001 - $250,000
$250,001+
Student-Athletes
Athletic Department Staff
General Student Body
University Employees
Former Athletes
General Public: 
How do we account for co-pays and deductibles?
Increase in our secondary insurance premium.
Documentation and Note Taking
How / do we need to be a contracted provider?
Can we /  should we use a billing and collections service?
Other: 
Other: 
Other: 
YesNo
Student-Athletes
Athletic Department Staff
General Student Body
University Employees
Former Athletes
General Public: 
Athletic Trainer
Physical Therapist
Physician (Physician Extender / Incident to Model)
Rehab. Post-surgical
Rehab. Time Loss (Including Surgical)
Physician Services (Office Visits)
Ancillary Services (Casting, Bracing, Wound Care, Orthotics, Etc.,)
0 - 56 - 1011 - 1516 - 2021 - 2526 - 3031 - 4041 - 5051 - 6061 - 7575+
$1 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - $75,000
$75,001 - $100,000
$100,001 - $150,000
$150,001 - $200,000
$200,001 - $250,000
$250,001+
Yes
No - An Athletic Trainer is resoponsible for that process
No - We use a billing service
No - Other
0%
1 - 25%
26 - 50%
51 - 75%
75 - 90%
91 - 100%
YesNo
YesNo