Medical Packet
Dear Athlete and Parent,
Welcome to Bellevue University and Bruin athletics. Soon, you will be starting a new season at Bellevue University. This letter is to bring you up to date with the latest in the athletic training room. Drug testing may be performed this year, this is not to alarm, but to reassure you and your parents we are interested in healthy athletes.
A medical packet is below and should be completed before you receive your physicals. Please read these forms. These forms give a better understanding of previous illnesses or injuries you may have sustained in the past. This information also improves our ability to contact family members and communicate with insurance companies in the event of a serious injury. Do not forget you must have health insurance in order to participate at Bellevue University.
IMPORTANT ACCIDENT INSURANCE INFORMATION AND CLAIM FILING INFORMATION
The following should be helpful in providing all responsible parties with the information necessary regarding the college’s secondary insurance plan and the procedures to follow after an injury.
The University requires that all athletes participating in intercollegiate sports be covered by a primary insurance plan before they are allowed to participate in such sports. Proof of such coverage will be required. In addition to your own primary insurance plan, Bellevue University also carries a secondary accident insurance policy which provides coverage to the University for student athletes participating in intercollegiate sports. This policy provides secondary coverage only after the student athlete has met their primary insurance policy deductible and has incurred $500 in additional out-of-pocket expenses per incident/accident effective during the 2008/09 academic year on any medical bills arising from the accident which caused injury while competing in athletics at Bellevue University. Payments made by the primary insurance carrier cannot be applied to the secondary insurance deductible of $500; this deductible consists of previously mentioned $500 in student athlete out-of-pocket expenses after primary insurance policy deductible has been met.
As an accidental insurance policy, it should be understood that the Bellevue University secondary insurance carrier determines whether an injury related to athletics is “accidental.” Pre-existing conditions are not covered; therefore, it is imperative that all injuries are immediately reported to the Head Athletic Trainer for accurate injury assessment, physician referral (if necessary) and appropriate documentation.
Bellevue University also carries a catastrophic accident insurance policy for students participating in intercollegiate sports. The policy is only applicable after $25,000 of accident costs have been incurred as a result of an intercollegiate injury.
If your primary insurance is with an out-of-state HMO health plan, I would strongly recommend that you purchase a temporary accident insurance policy (above). There is not an HMO provider close to the college
campus. As a result, students with HMO coverage will generally be required by their insurance carrier to return home for any medical care and procedures beyond basic emergency services, even after receiving an initial assessment from the college’s medical team. I recommend that students with HMO’s check their policy on this issue and seriously consider purchasing a temporary accident insurance policy in order to receive local medical care and rehabilitation if deemed necessary. Please note that the colleges’ secondary insurance plan will not make payment in the absence of an HMO’s refusal to meet the $500.00 deductible if you receive services here without first gaining approval from your provider for payment.
PROCEDURES FOLLOWING INJURY
1. Notify the Certified Athletic Trainer of any injury immediately. First Agency Insurance will not be responsible for charges incurred by the athlete outside the medical network which has been established, if not first seen and approved by the Certified Athletic Trainer.
2. Be seen by the team physician (a medical doctor) on a per referral basis arranged by the Certified Athletic Trainer if necessary.
3. Your primary insurance will be directly billed for all services deemed necessary by the team physician at the time the services are rendered. If the cost of these services exceeds the deductible required to satisfy the colleges’ secondary insurance, the certified athletic training staff will file a claim to the Colleges’ secondary insurance plan on your behalf. Once this has been done, the claim will be sent to the Colleges’ insurance company for processing. You will receive a letter of confirmation from First Agency Insurance regarding the status of your claim and any request for additional information.
4. Be advised that after you receive this letter of confirmation from First Agency Insurance., you should correspond directly with them thereafter in order to expedite the process and payment of your claim. Claims representative at First Agency Ins. for Nebraska can be reached at 269-381-6630.
Bellevue University’s athletic department utilizes the best physicians in the Omaha/Bellevue area to give our athletes excellent care without the delay of appointments or lines if they become sick or injured. As the forms enclosed are reviewed you may notice that permission is granted for athletic training department at Bellevue University to render care as needed for the health and well-being of its athletes, this is solely to provide the quickest and best possible care for you or your son or daughter. I hope this will help those that may have to deal with this issue.
If there are any questions on this matter please call. (402) 557-7057.
Physical and release forms must be completed and returned to my office before practice starts in August. If this is not accomplished you will not be allowed to participate in practices. If you do not have a family physician, the team physicians are performing physical exams on August 4th & August 27th. The cost will be $10. Physicals are on the main campus in the Gordon Lozier Athletic Center.
Please contact your coach for specific times for each team.
Please do not forget to complete the forms and enjoy the summer.
Sincerely,
Michael Livergood, MS, ATC, CSCS
Head Athletic Trainer