Insurance Reimbursement: Easy Money. Part 2

There are many types of services fitness professionals seek reimbursement for, including health education programs for smoking cessation, stress management or weight management, health intervention services such as fitness assessments, health-risk appraisals and pre-exercise screenings, and exercise and recreation programs that can improve fitness levels. In addition, there could be reimbursement for “post-rehabilitation,” also called extended care, fitness therapy, post-rehab fitness and medical fitness.

Yet the problem with obtaining reimbursement lies in the standardization of care. What is the definition of a fitness professional today? Are fitness professionals personal trainers, massage therapists, aerobics instructors, nutritionists, yoga instructors or anyone that works in a health club? What is the minimum educational requirement to be called a fitness professional? Is it a high school diploma, a two-year associate’s degree, a four-year bachelor’s degree, or a master’s or doctorate post-graduate degree? What areas of study are recognized: physical education, exercise physiology, kinesiology, sports medicine, health, corporate wellness, etc.? What type of certification is required, if any? How do you differentiate between the many certification organizations? The best estimate is that there are more than 200 certification bodies for the health club industry.

Reimbursement requires change

To understand the changes that need to occur within the health club industry in order to receive reimbursement for services, it is probably best to examine the segment of the healthcare industry that currently receives reimbursement. All of the questions posed above have been answered for hospitals, physicians, physical therapists, chiropractors and nurses (RN and LVN). The healthcare industry requires a college degree and specific certification, licensure and accreditation. In short, it requires specific responsibilities and accountability, and is heavily regulated by either a government agency or an accrediting association. Compare this to the health club industry that has no nationally recognized standards of operation and is basically unregulated.

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