Biomaterial Database

Conducting a third-party reimbursement survey: experience of the Connecticut Nutrition Services Payment Systems Committee. 1990

L S Bell, and G Chavent, and N Hessler, and M Zehalla

Department of Food Services, Hospital of Saint Raphael, New Haven, Connecticut 06511.

Third-party reimbursement (TPR) has emerged as a crucial issue for dietetics in the past decade. To investigate the level of TPR being obtained by individuals receiving nutrition services from registered dietitians in ambulatory settings, the Connecticut Nutrition Services Payment Systems (NSPS) Committee conducted an audit. Sixty survey packets were distributed to consulting dietitians in private practice and to dietitians in outpatient nutrition clinics. Twenty dietitians participated in the audit process, providing 99 client responses to the survey. Sixty-seven percent of clients submitted the charges for nutrition services to their insurance companies, but only 17% received reimbursement for the claims submitted. This audit process raised the level of awareness of the state membership regarding the need to aggressively pursue TPR for nutrition services at all levels, and it provided a model for dietitians to use to conduct periodic audits and assess TPR being received by their clients.

UI	MeSH Term	Description	Entries
D007349	Insurance, Health, Reimbursement	Payment by a third-party payer in a sum equal to the amount expended by a health care provider or facility for health services rendered to an insured or program beneficiary. (From Facts on File Dictionary of Health Care Management, 1988)	Health Insurance Reimbursement,Reimbursement, Health Insurance,Third-Party Payments,Third-Party Payers,Health Insurance Reimbursements,Insurance Reimbursement, Health,Insurance Reimbursements, Health,Payer, Third-Party,Payers, Third-Party,Payment, Third-Party,Payments, Third-Party,Reimbursements, Health Insurance,Third Party Payers,Third Party Payments,Third-Party Payer,Third-Party Payment
D003237	Connecticut	State bounded on the north by Massachusetts, on the east by Rhode Island, on the south by Long Island Sound, and on the west by New York.
D003625	Data Collection	Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.	Data Collection Methods,Dual Data Collection,Collection Method, Data,Collection Methods, Data,Collection, Data,Collection, Dual Data,Data Collection Method,Method, Data Collection,Methods, Data Collection
D004045	Dietary Services	Services provided by dietitians or nutritionists to meet the nutritional needs of individuals, including consultation with other professional personnel.	Services, Dietary,Dietary Service,Service, Dietary
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man