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 United HealthCare?
All athletic injury claims must be filed through Athletic Training
Services. Therefore, injured athletes should report their
injury to the Athletic Training Staff
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.
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 United HealthCare Policy
is an "Excess" or "Secondary" policy. They will only consider
bills that have been processed through your Primary Insurance Carrier
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):
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 (including co-pays).
5. 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, United
HealthCare will also deny these bills. It is imperative
to follow the procedures established by your HMO.
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.
6. 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 United HealthCare will consider most unpaid balances, when
the proper paperwork is received.
7. 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 United HealthCare will consider
all unpaid balances, when the proper paper work is received.
8. How are bills processed?
Each medical provider should bill your primary insurance first
and then United HealthCare as your secondary insurance.
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.
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. Maintain copies of 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.
Receipts for co-pays should be sent to:
Richard Stockton College
Athletic Training Services- Sports Center 309
PO Box 195
Pomona NJ, 08240
10. Who can we contact with questions
Chris Klenk, MEd, ATC, CSCS- Assistant Athletic Trainer/ Email:
Jessica Spencer, MA, ATC- Athletic Trainer/ Email: email@example.com
Jon Heck, MS, ATC- Associate Director of Athletics and Recreation/