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Published byCathleen Glenn Modified over 8 years ago
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Reducing the Risk of Litigation
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Coach Warn athletes of potential dangers involved in sport Supervise regularly and attentively Prepare and condition athletes Instruct athletes on skills of their respective sports Ensure proper and safe equipment and facilities
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Athletic Trainer Work to establish good working relationships with athletes, parents and coworkers Establish policies regarding athletic training facility and coverage Develop emergency action plan Know the medical history of athletes Maintain adequate records
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Detailed job description Obtain written consent relative to providing health care Maintain confidentiality Exercise caution with regards to medication distribution and modality use Ensure safe equipment and facilities
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Follow physician’s orders, particularly when dealing with participation of athlete Purchase liability insurance Know scope of practice Use common sense
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Product Liability Liability of any or all parties involved in manufactured product for damages caused by product –Includes manufacturer of components, assemblers, wholesaler, and retail store owner Products with inherent defects are subject to liability suits May be based on negligence, strict liability or breach of warranty fitness
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Manufacturer of equipment has duty to design and produce equipment that will not cause injury Express warranty –Manufacturer’s written guarantee – product safety Equipment warning labels –Informs athlete of possible dangers inherent with product use –National Operating Committee on Standards for Athletic Equipment (NOCSAE) Minimum standards for equipment to ensure safety
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Athletic trainers should not alter equipment –Doing so invalidates the manufacturers warranty –Results in placing liability solely on the athletic trainer
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Workers Compensation Laws and benefits for injured workers are mandated by states Employer pays premiums Claims are settled by workers compensation insurance carriers Insurance carrier goal – return worker to work as soon as possible
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Indemnity Plan Most traditional form of billing for health care Fee-for-service plan that allows insured party to seek care without restrictions Provider charges patient or third-party payer Charges are set on fee schedule
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Capitation Form of reimbursement where members make standard payment monthly regardless of services rendered Managed care plans utilize this practice
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Third-Party Reimbursement for Athletic Trainers ATC’s have been able to bill third parties Most insurance companies refuse to reimburse Recently, increase in reimbursement in a variety of settings State licensing and credentialing will aid in this process but will remain concern for clinical ATC’s
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Reimbursement Advisory Group (NATA) responsible for assessing managed care and involvement of ATC’s Athletic Training Outcome Assessment project (NATA) developed to present results of 3 year study –Study focussed on functional outcomes, perceptions of care, physical, social, mental well-being, time lost due to injury and satisfaction of care and treatment Third-party payers require outcomes research when evaluating a contract
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Insurance Billing Must file claims immediately and correctly To facilitate, collect insurance information at the start of the academic year Letters should be sent home to fully explain the coverage available and necessary procedures Standard forms are the norm, but accurate and thorough completion is critical
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Filing an Insurance Claim Standard forms are utilized –Must be complete and detailed –More accuracy and thoroughness = quick return and higher rate of reimbursement Billing Codes –Diagnostic code Specifies injury/condition that is being treated –Procedural code
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ATC in clinical setting must be aware of third-party billing procedures May need to request approval from insurance companies for treatments to be rendered Billing must be in accordance with Current Procedural Terminology set by AMA Thorough record keeping is critical throughout the process
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