The goal of the Athletic Department is to provide the best health care delivery system for student-athletes at University of New Hampshire.
The information below will help explain, procedures for physician referrals and for filing insurance claims.
The Athletics Department has carries an excess insurance policy for student-athletes. The policy will be applied to medical costs incurred for services rendered by authorized health care providers for athletic injuries only.
The policy is only applicable for injuries and illnesses that are a direct result of intercollegiate activity during a required practice or competition supervised by a staff member of the Athletics Department. The parents of the student-athlete must complete an annual medical insurance information form regarding the insurance company that provides coverage for the student-athlete. This form must be submitted to the athletic training staff at the beginning of each academic year
How does the
Department's insurance policy work?
University of New Hampshire?s insurance policy requires that the injured student-athlete make an initial claim under their primary insurance (parent's policy or one owned by the student athlete). The athletic training staff provides this information to our medical care providers. It is the medical care provider who files a claim with your insurance company for services rendered. Your primary insurance company will evaluate and either pay or deny the claim. The insurance company will send you a statement, Explanation of Benefits (EOB), which shows that they have paid or denied. The provider will send you a bill for services rendered and will continue to send you statements until the claim is paid.
If you have not received any information from your insurance company within 45 days after the date of injury, you should call your insurance company and question the status of your claim. If necessary, resubmit the bill from the Provider to your insurance company.
The student athlete or parent should provide copies of all information from insurance company(s) and medical providers to the athletic training staff.
All claims must be resolved within 2 years (104 weeks) from the date of injury.
Prior written authorization from the Department's Team Physician must be obtained if a student-athlete wants medical attention outside of the Department's network.
If a student athlete seeks a second opinion or care from a non-authorized provider, he/she will be medically ineligible to participate until all medical records are reviewed by the Team Physician. Additionally, the university will not assume any financial responsibility for non-authorized services.
What if I
belong to an HMO or PPO?
If you belong to a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO) insurance company, they may limit their reimbursement. YOU are requested to provide the athletic training staff with the specific instructions, requirements and limitation of your insurance coverage.
What is NOT covered under UNH's Excess Insurance Policy?
* Injury sustained in an activity that is not associated with a required intercollegiate practice or competition supervised by a coach.
* A chronic or recurrent injury that was sustained prior to participation at UNH
* Unauthorized consultations or treatments.
* New injuries that occur after the student-athletes eligibility is exhausted.
* Medical costs after the student athlete's eligibility is exhausted.
* Conditions as a result of non-compliance with the school?s policies, team rules, or the advice of the team physician, attending physicians, the athletic trainers or coach.
* Deductibles or co-pays required by your Primary insurance (does unh cover this)
What are the parent?s and/or student athlete?s responsibilities?
It must be clearly understood that you and your child are financially responsible for all charges for the care of an athletic injury and the resolution of all claims. The Athletic Department of University of New Hampshire assumes no financial liability for expenses generated fro medical care of the student-athlete. This is not an all inclusive policy and benefits will be applied subject to the terms and limitations of the policy.
In addition, the parents and/or student-athletes have the responsibility to follow the proper procedure to access the excess insurance policy to seek benefits for the charges that arise from an athletic injury. Again, all charges are ultimately the responsibility of the student-athlete. Therefore, if the threat of collection or garnishment of wages arises from an unpaid bill, the parent and/or the student-athletes are strongly encouraged to pay all balances to avoid harm to his or her credit rather than wait for the insurance company to decide on benefits.
FREQUENTLY ASKED QUESTIONS
Q: WHAT IF I RECEIVE A MEDICAL BILL IN THE MAIL, WHAT DO I DO WITH IT?
A: If you receive a medical bill in the mail, and Koster is your Primary insurance you should ALWAYS forward it to your athletic trainer. The athletic trainer will then forward it Koster Insurance.
Q: WHAT IS AN EXPLANATION OF BENEFITS (EOB)?
A: An Explanation of Benefits is a form sent to you or to the medical provider explaining exactly what your primary health insurance provider will or will not cover. It gives you information such as the date of service, the medical providers name, the medical facility?s name, the amount of the bill, whether the bill was paid, the amount of payment, whether it was applied to the deductible or rejected and the reason for rejections. Most out of state health insurance providers will send the explanation of benefits directly to the policy holder.
Q: WHY IS IT NECESSARY TO FORWARD THE EXPLANATION OF BENEFITS TO THE ATHLETIC INSURANCE COORDINATOR?
A: Without a copy of the explanation of benefits, Koster insurance cannot make payment on any medical bills or claims, This form verifies that the bill was filed with your primary health insurance provider, and that action was taken on their behalf.
Provide primary insurance coverage information and a copy of your insurance card.
Student-athletes must have prior approval for medical services.
Respond promptly to all requests by insurance companies.
Send EOB's and provider statements to the Athletic Insurance Coordinator.
Contact the Athletic Insurance coordinator if you have any questions.
The Athletics Department Insurance Coordinator Cynthia Michaud Assistant Athletic Trainer
603-862-4987 fax: 603-862-4198