SBJ/Feb. 22-28, 2016/Colleges

Firm targets training rooms’ revenue potential

A Dallas-based technology company is working with college athletic departments to turn their training rooms into new revenue centers.

More than 100 schools across all NCAA divisions have turned their athletes’ medical insurance claims over to Vivature Sports, a third-party billing service that collects payment on the claims and shares the money with the school.

Vivature has been in the marketplace pitching this model to schools for the last few years, but its client base has grown more rapidly in the past year as athletic departments seek new revenue streams and the issue of athlete welfare has taken on a heightened profile.

Vivature helps colleges file insurance claims for treatment provided to injured athletes.
Photo by: AP IMAGES
Vivature’s model guarantees the school a set amount of revenue from the insurance claims, many of which were never filed in the past, company officials say. Those guarantees range from the low to mid-six figures per year, representing all new revenue for the athletic department. The guarantee model is based off the multimedia rights contracts that so many schools have with their third-party rights holders.

An alternate model enables schools to share in the claim reimbursements instead of taking the guarantee.

Vivature figures it will collect more money in claims, through its software and database, than it guarantees to the school. The company estimates a 25 percent to 30 percent margin on most deals.

“They’ve found an interesting niche in the marketplace,” said Hunter Yurachek, the University of Houston’s athletic director and a Vivature client.

The key, Vivature executives say, is to start treating the school’s training room like a medical center, such as a sports clinic or an orthopedic doctor’s office. Those offices perform many of the same treatments as a school’s training room, but the difference is that the medical center routinely files claims with insurance companies for reimbursement, while most college training rooms do not.

Vivature officials say that athletic training rooms are behind the times when it comes to filing claims. The company’s sales pitch pushes the software, which does most of the work for the trainers. By working with the trainers to more accurately account for each visit by an athlete and then file claims on those visits, Vivature believes it will produce more revenue for the school.

The company also touts its software as a better way to document the hundreds of athletes who receive treatment each week.

“The training room is easily the busiest medical center I’ve ever seen,” said Muzzy Bass, Vivature’s chief executive and a 30-year veteran of working with companies on human resources and group insurance. “The schools should be getting paid by insurance companies for the work that they’re doing.”

At most schools, athletes arrive on campus with their own insurance, often through a parent’s job. Medical claims are first filed against the athlete’s insurance. If an athlete doesn’t have insurance, the school’s secondary insurance policy covers the athlete. But unlike most medical centers that have automated methods for filing insurance, many athletic training rooms do not.

Vivature will provide the software and the manpower to file the insurance claims for the trainers, just as the company does for other medical facilities. The service includes several steps, including seeking pre-approval from insurance for certain medical procedures, getting team doctors credentialed by insurance companies, and filing claims with the appropriate coding for each doctor-prescribed treatment.

“The biggest concern we had was making sure an athlete’s insurance was accurate,” said Joe Joe Petrone, Auburn’s director of sports medicine and a veteran of 30-plus years as an athletic trainer. “We had no way to do that, and without that, insurance companies would not talk with us. It was a nightmare.”

Vivature last year began providing its third-party billing and collection system for Auburn. Vivature’s other clients include BYU, Houston, Georgia Southern and Louisiana-Monroe, among others. Officials said deals with Texas A&M and Washington State are in the works.

“They have the system to take the athlete’s insurance, get it verified every month and keep it compliant,” Petrone said. “They keep everything up to date and accurate.”

Vivature’s model, however, has raised some concerns in the athletic training field. Some are admittedly skeptical about insurance companies processing claims for every sprained ankle or strained hamstring.

“I get nervous when we start talking about profiting from insurance,” said Dr. Rod Walters, formerly the head trainer at South Carolina and Appalachian State. Walters now consults with athletic departments and training facilities, and admits that most of his focus is on cost-cutting, not revenue generation.

“I mean, hospitals are going broke these days,” Walters said. “How do we think we’re going to go into college athletics, which doesn’t do this for a living, and make money off it?

“There is a good concept here. My challenge is going to the AD and saying that we can turn your training room into a profit center. I just want to make sure the athletes remain at the core of what we’re doing.”

But Joe Giansante, Vivature’s chief marketer, said schools spend millions each year in medical and training room costs. So getting $200,000 to $300,000 back from claims is far from creating a profit center.

“Now the schools are just getting a check as opposed to operating a huge, free clinic,” Giansante said.

Pat Souter, a 25-year health care attorney and law professor at Baylor University, has consulted with Vivature on this model. As long as schools and Vivature follow the basic protocol — validate the athlete’s insurance, seek pre-approval for doctor-prescribed treatment, use credentialed doctors and trainers, and file claims with the proper coding — insurance companies are obligated to pay the claim, he said.

“If you lay the groundwork and jump through the hoops up front, you’re just submitting a claim on a covered charge, just like any other covered charge,” Souter said. “There’s no difference between going to a training room or an orthopedic doctor. If it’s something the insurance company has a code for, and the treatment is medically necessary, there’s really no difference. The athletic trainer is just a different kind of health care provider.”

Vivature’s parent company, Orchestrate HR, has been around since the 1960s and regularly consults with companies and medical centers on human resources, insurance and benefits issues. Bass said Vivature saw a need inside athletic departments in recent years and has been working on a strategy to sell its service to athletic departments. One of the early missteps was trying to convince trainers to buy the service. Now they go straight to athletic directors with a core message around revenue and improved accountability for what happens in the training room.

Vivature brought on Giansante, a former associate athletic director at Syracuse and Oregon, in April. Jim Livengood, a former AD at UNLV, Arizona and other schools, is a senior consultant with Vivature as well. Livengood is using his relationships to target schools in the power five conferences.

“The biggest thing is that this represents a new source of revenue for athletic programs,” Livengood said. “The software that’s put in place also provides a much higher level of documentation for the athletes who are going to the training room every day.”

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