Insurance Reimbursement: Easy Money. Part 1

Getting reimbursement for fitness services from health insurers is an unrealized dream for most facilities. Here’s what you’re up against.

For fitness professionals to be recognized as true healthcare professionals who are eligible for insurance reimbursement, they must be ready to make some changes. First, fitness professionals in the next century must be prepared to answer some key questions, such as, “What services and programs will generate revenue,” and “How will those services and programs be paid for?” Second, as the health club industry moves from a sales-driven industry to one with a focus on service and outcomes management, new knowledge, new skills and new attitudes will be necessary to succeed.

The state of the industry today

The questions I am most often asked are, “Why don’t insurance companies subsidize health club memberships,” and “Why don’t insurance companies pay for post-rehab personal training?”

To discuss the direction of insurance reimbursement for fitness professionals, we must first identify the type of insurance reimbursement and then the kind of services we want reimbursed. We’ll assume in this discussion that we’re dealing with a health-related or injury-related commercial insurance company, such as indemnity insurance, an HMO, PPO, PIP or workers’ comp insurance. For now, we can eliminate government agencies such as Medicare and Medicaid, since they are unique.

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