1. How is
my son or daughter covered by the athletic insurance policy?
In order to be eligible for coverage each athlete must pass their
athletic physical at Stockton College. Once cleared medically
to participate, every intercollegiate athlete is covered automatically.
Back to questions.
2. Who will file a claim with Bollinger?
All athletic injury claims must be filed through Athletic Training
Services. Therefore, injured athletes should report their
injury to the Coordinator of Athletic Training
(Jon Heck) and discuss their injury situation before seeing
a physician. Failure to do so may forfeit coverage for
that injury. Obviously this does not pertain to emergency
or emergency room situations where immediate medical care is required.
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3. Whose insurance will be the primary
carrier?
If your son/ daughter is covered by any type of personal insurance,
that company will serve as the Primary Insurance Coverage.
This is not an option, your personal coverage will always
serve on a primary basis. The Bollinger Policy is
an "Excess" or "Secondary" policy. They will only consider
bills that have been processed through your Primary Insurance Carrier
first. Back to questions.
4. What is covered by the athletic policy?
Generally, the policy covers athletic related injuries that occur
during supervised and scheduled athletic practices and games.
All of the following will be considered by Bollinger with the proper
paper work (this is not a complete list, however):
1. Deductables
2. Co-Pays
3. Prescriptions
4. Hospital Bills
5. MRI/ Diagnostic Testing Bills
6. Emergency Room Bills
7. Physician Bills
8. Knee Braces
***You should obtain a receipt & itemized bill for any bills
you pay directly yourself. Back to questions.
5. What does Bollinger require to process
medical bills?
1. A injury claim must already be filed (see
# 2). 2. An Itemized Bill from each service provider.
An Itemized Bill details the charges for each item that makes
up the total bill. A bill that only shows a "total charge" is
not acceptable to process a claim.
3. Explanation of Benefits (EOB) from your primary insurance
carrier for each medical bill. An EOB explains what your
insurance carrier covered or denied from each medical bill.
Your primary insurance carrier will normally mail you an EOB after
they have considered any medical bills. A claim must be
filed before you will recieve an EOB from your primary insurance
company.
****Unless Bollinger has all three of these items, a bill will
not be considered. Back to questions.
6. What if we have an HMO?
An HMO requires a referral from your primary care physician before
any medical care is received (other than emergencies). If
these procedures are not followed your HMO will deny all medical
bills. If your HMO denies your bills for this reason, Bollinger
will also deny these bills. It is imperative to follow
the procedures established by your HMO. HMO's are the most
restrictive type of medical insurance. You are limited to
physicians and medical care that is within the HMO's network.
They also usually lengthen the time it takes for an athlete to
initially see an orthopedist because a referral must be obtained
before the athlete is seen for an injury. And it's also
possible the primary care physican will want to see the athlete
first, before a referral is made. Back
to questions.
7. What if we have a PPO?
There are several types of PPO's, but all of them provide more liberal
coverage than HMO's. Some PPO's do not require a referral
as long as the physician who is seen is in their network of providers.
For full benefits some PPO's require a referral from your primary
care physician. But all PPO's we have come in contact with,
provide coverage for "out of network" services. This means
if a referral is not obtained or a network physician is not used
they still provide partial coverage (usually reduced benefits, with
a deductable). As long as the PPO provides partial coverage
then Bollinger will consider most unpaid balances, when the proper
paperwork is received. Back to
questions.
8. What if we have a "Traditional
Plan"?
The "Traditional Plan" with an insurance company provides the best
of all possible worlds. Referrals are not required and coverage
is open to any physican, hospital, or medical facility. These
plans normally have a deductable and Bollinger will consider all
unpaid balances, when the proper paper work is received. Back
to questions.
9. What is our responsibility in
this process?
1. For emergency rooms visits, make sure your insurance company
is contacted, if they require this for coverage. 2. Make
sure a claim has been filed with your primary insurance company
for each medical service provider (many times hospitals do not
do this for you, especially with emergency room visits).
3. Obtain all of the required itemized bills, receipts, and EOB's
required by Bollinger.
***We suggest you make a folder and keep any and all of
the information you receive regarding the athletic injury here
for future reference. Back to questions.
10. Where do we send bills and
EOB's?
Once you obtain itemized bills, receipts, or EOB's, copies should
be sent to the following address: Richard Stockton College
Jon Heck- Athletic Training
PO Box 195
Pomona NJ 08240-0195
We will then forward the paperwork on to Bollinger with the identifiers
they require for claim processing. We will also keep a copy
of all paperwork in the athletes file for future reference.
Back to questions.
11. Who can we contact with questions
or problems? From Stockton:
Jon Heck
Coordinator of Athletic Training
609-652-4952
Email: heckj@stockton.edu
From Bollinger
| |
Secondary Claims
Contact
Robyn T.
1800-526-1379 ext.8031 |
Claims Supervisor
Don Jenkins
1800-526-1379
ext. 8007 |
Senior Vice President
Joe Mignon
(pronounced, "Minyon")
1800-526-1379
ext. 8055 |
Back to questions. |