States and NATA Districts seeking to professionalize advocacy, advance education, and generate knowledge relative to third party reimbursement may apply for this grant as part of the NATA’s Third Party Reimbursement Initiative (TPRI). The intent of this grant is to encourage financial and resource investment that is shared by States, Districts, and the NATA, and to encourage a standardized and coordinated approach to third party reimbursement to the greatest extent achievable.
Funding will be provided through a matching grant system. If awarded, the NATA will match up to 50% of state or district association expenses. This maximum match for districts will be $25,000.00 annually and the maximum match for states will be $10,000.00 annually based upon the NATA fiscal year of July 1 – June 30th. Grants will be reviewed and awarded on a biannual basis.
States and NATA Districts are both eligible to apply as long as efforts are not utilized to fund the same effort.
Matching grant clarification: The intent of the matching grant program is to match up to 50% (maximum of $10,000 for states and $25,000 for districts) of funds already spent by a state/district on third party reimbursement efforts during a fiscal year. For example, if a state incurred $10,000 of eligible expenses relative to third party reimbursement efforts during a fiscal year, the state would be eligible for grant funding of up to $5,000 for that fiscal year.
Approved use of grant funds within a state or district include:
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Reimbursement for the time of an individual dedicated to leading third-party reimbursement advocacy efforts within a state or district.
- Support of legal fees necessary to secure efforts and opinions related to advancing third-party reimbursement efforts within the state or district. This includes efforts related to updating language in practice acts when applicable. Strictly relative to reimbursement.
- Networking and relationship building efforts with third-party payors, employers, entities that secure prior authorization for payment, or other key stakeholders influencing third-party reimbursement efforts within the state/district.
- Tools utilized for data collection, marketing and communication with state/district and national membership.
- Development of educational content aimed at sharing key learnings with membership within the state/district and nationally.
- Clarification: Grant funding through the TPRI matching grant program will not be approved for expenses that are eligible for reimbursement by the NATA’s Governmental Affairs Grant program. All lobbying expenses should be applied for via the NATA Governmental Affairs Grant Program.
States and NATA Districts receiving grant funding will be responsible for:
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Collaborating with national TPRI team representatives to identify capable individuals or teams responsible for professionally leading TPRI efforts within the state or district.
- Ensuring that identified state or district TPRI leaders are held accountable for maintaining effective communication with overall state/district association leadership.
- Assisting identified state or district TPRI leaders in developing relationships with key external stakeholders to include payor representatives.
This will need to be reported as part of the grant renewal process:
- Partnering with national TPRI leadership to develop and maintain a budget specific to third party reimbursement efforts. This includes ensuring compliance with reimbursement policies set forth by the NATA and TPRI leadership for the utilization of grant related funds.
- Completion of an annual report summarizing overall TPRI effort and progress.
Application Process
Applications for the NATA Third Party Reimbursement matching grant will be accepted twice during the fiscal year. A round of applications will be accepted by October 1 and April 15 annually. Applications must be completed in their entirety and signed by the respective state or district association president to be considered. Note that states or districts can apply for grant funding twice annually, however, only new expenses not previously covered by NATA grant funding will be considered for funding. Completed applications are to be submitted through the online application form.
Reporting Considerations
While not required for approval of grant funding, a key aspect of the NATA Third Party Reimbursement Initiative is to track the progress made across the country to allow us to understand the progression of the profession relative to third party reimbursement.
This would include maintaining accurate records and reporting relative to:
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Specific payors that are reimbursing and denying claims from athletic trainers.
- Employers that are utilizing athletic trainers to successfully gain reimbursement.
- The volume of athletic trainers functioning in a reimbursable capacity.
To assist in this process, states and districts are asked to include in their application a current assessment relative to third-party reimbursement efforts. While it is expected that not all of the metrics requested below may be available at the time of application, participants in the grant process are asked to consider a process to begin, or continue, collecting this information. It is important to note that this data collection is not intended to be a deterrent from submitting a grant application. Leaders should contact their TPRI Regional Coordinator with questions relative to this process. Note that applications will still be considered even if this type of information is not yet available.
When available, ideal metrics should include objective documentation of the following:
- The number of payors* that reimburse for Physical Medicine and Rehabilitation codes delivered autonomously by athletic trainers.
This is defined as the number of payors that reimburse for athletic trainers that bill for Evaluation and Re-Evaluation CPT Codes (97169 – 97172) and the subsequent associated Physical Medicine and Rehabilitation codes. Revenue Code 951 should be used if needed.
- Commercial
- Government
- Workers Compensation
*Specific payors that have provided and denied reimbursement will ideally be identified.
- The number of employers that are utilizing athletic trainers as billable providers.
This is defined as the overall number of employers that use athletic trainers to bill for Evaluation and Re-Evaluation CPT Codes (97169 – 97172) and the subsequent associated Physical Medicine and Rehabilitation codes. Revenue Code 951 should be used if needed.
- The number of athletic trainers that are working in a capacity where they bill and receive reimbursement for athletic training services.
This is defined as the overall number of athletic trainers that bill for Evaluation and Re-Evaluation CPT Codes (97169 – 97172) and the subsequent associated Physical Medicine and Rehabilitation codes. Revenue Code 951 should be used if needed.
Additional requirements as part of the application include demographic information relative to the number of athletic trainers actively practicing within the state or district, practice act information, and a review of efforts relative to third-party reimbursement to date. Please see the application for additional information and requirements.
Award Notification and Funds Disbursement
Notification of grant award or denial will occur within 30 days of the receipt of a completed application by the TPRI team. Matching grants are awarded in lump sum after approval and after submission of required documentation. Please allow two weeks for processing. Checks are mailed to the individual and address indicated on the application. All receipts with documentation must be provided by June 1 of the given year to allow for processing by close of the fiscal year. A sample documentation form is provided with the application.
Grant Application
- Access and complete the online Third Party Reimbursement Initiative Matching Grant Application.
- Submit completed application by the October 1 or April 15 deadline.
- For questions and for more information on the application process, please contact Courtney Havens at chavensmitchell@gmail.com or via phone at (269) 993-7978.