Third-Party Reimbursement for Diabetes Outpatient Education: A Manual for Health Care Professionals
Author: Task Force on Financing Quality Health Care for Persons with Diabetes
Date Published: 1986
The twofold purpose of this manual is to provide: (1) guidelines for requesting third-party reimbursement for diabetes outpatient education from a third-party payer, and (2) supporting data and information that can be used to document the need for reimbursement. The manual is based on the experiences of programs that have successfully obtained such reimbursement. In some cases, reimbursement was easily achieved; in others, it was a long, arduous task. There is no proven formula that will work for every education program with every third-party payer. Each diabetes outpatient education program is unique to the individuals it serves, its environment, and the third-party payers with whom it interacts. Section I of the manual includes a description of the health insurance system, the steps applicable to specific third-party payers. Section II reviews the data that demonstrate the cost savings associated with diabetes education and the impact of diabetes outpatient education programs on the utilization of health services and summarizes the current status of reimbursement for diabetes outpatient education by the major third-party payers.
Date Published: 1986
The twofold purpose of this manual is to provide: (1) guidelines for requesting third-party reimbursement for diabetes outpatient education from a third-party payer, and (2) supporting data and information that can be used to document the need for reimbursement. The manual is based on the experiences of programs that have successfully obtained such reimbursement. In some cases, reimbursement was easily achieved; in others, it was a long, arduous task. There is no proven formula that will work for every education program with every third-party payer. Each diabetes outpatient education program is unique to the individuals it serves, its environment, and the third-party payers with whom it interacts. Section I of the manual includes a description of the health insurance system, the steps applicable to specific third-party payers. Section II reviews the data that demonstrate the cost savings associated with diabetes education and the impact of diabetes outpatient education programs on the utilization of health services and summarizes the current status of reimbursement for diabetes outpatient education by the major third-party payers.
