Dear Student-Athletes and Parents,
While participation in collegiate athletics can produce an array of emotions for both athlete and the parents, anxiety over who is responsible to pay for medical bills should not be one of them. Here at Wright State University, we have put in place an insurance policy that will help cover approved medical expenses that may occur while participating in intercollegiate athletics while at Wright State University. However, it is the responsibility of the athletes and/or parents to provide all pertinent information requested and to follow the procedure listed below. Please use the navigation tabs listed below to be directed to the desired section. Athletes will not be allowed to participate without current information (including copies of insurance card). Please feel free to contact me directly with any further questions. Â
Thank you,
Adam Horseman, AT, ATC, MS
Athletic Trainer / Insurance Coordinator Â
(937) 245-7553Â
adam.horseman@wright.edu
Overview
It is the policy of the Sports Medicine Department to only cover medical expenses directly related to participation in intercollegiate athletics and only if the charges were initiated or authorized by a member of the Sports Medicine Staff.
These charges will be paid by A-G Administrators, which is the third party insurance provider for the Wright State University Athletic Department. The policy that we carry is not a secondary policy for the individual athletes, but rather a policy that the athletic department uses to protect itself from excessive financial loss due to athletic injury. Per our athletic department policy, no charges from physicians or services outside our physician group, unless directly referred by a team physician or staff athletic trainer, will be accepted for payment.
The payment process can be time consuming, so it is imperative that the student athlete bring in all EOB's and medical bills in a timely manner. We recommend checking to verify that these bills have made it to the athletic training room from your son or daughter, as experience has shown, the dorm room has been known to hide, tear, or destroy bills and letters. We also encourage you to make copies of all items that you submit for your own records and to forward all bills you receive, even if they are a duplicate, which will allow us to check the status of outstanding accounts.
Please note that Wright State University assumes no responsibility whatsoever for any uninsured medical expenses (i.e. incomplete paperwork, out of network providers, no pre-certification, etc.) and we strongly recommend that the student-athlete have coverage through a primary insurer to avoid possible, significant out-of-pocket expenses in the event of an injury.
The NCAA does provide a Catastrophic Injury Insurance Program that will cover any catastrophic injuries that occur while participating in a covered intercollegiate event. The policy has a $90,000 deductible that must be met (two year period after date of injury) and is considered supplemental coverage in the event of a catastrophic injury. More information can be found on the NCAA website at www.ncaa.org.
Payment Procedure
In accordance with our insurance policy, the following steps must be completed in order to have medical accounts paid. Please note that all charges must be submitted in a timely manner.  Â
1. In the case that any medical expenses directly related to the participation in intercollegiate sports occur, all charges need to be submitted to the primary insurance of the athlete. After the primary insurance payment, the individual (or family) will receive an Explanation of Benefits (EOB). Due to changes in the accessibility of personal information (HIPAA), we are no longer able to request an EOB from your insurance company. You may need to call your insurance provider to obtain an EOB if one is not automatically sent out to you.Â
2. This statement (EOB), and any bills from the provider of services may then be submitted to the athletic training room. All bills must be detailed with date of service provider, procedure and amount due. We can request these bills, but this will delay the payment process.Â
3. Once the charges are accepted as the responsibility of the athletic department, a claim will be created and sent to A-G Administrators, who will work on behalf of Wright State University to process and pay any outstanding medical expenses.Â
It is impossible for us to process a claim without the above mentioned items, which will ultimately slow the payment process. Remember, the bill is in the athletes name and will remain outstanding until we are provided all required information and are in compliance with the terms of payment from A-G Administrators. If you ever have any questions on the status of your account, please do not hesitate to contact the athletic training room at (937) 245-7550
How/Where to Submit
All medical bills and EOB's are able to be submitted in the following ways.Â
- Hand delivered by the athlete to the athletic training room (140 Nutter Center)
-Mail to:
Adam Horseman
Wright State Physicians Building
Athletic Training Offices
725 University Boulevard
Dayton, Ohio 45435-0001
- Or fax to (937) 425-0736
FAQ/Important Information
Q. Will my premiums increase if my son or daughter stays on my insurance?
A. No they will not. Health insurance does not increase on a yearly basis because of individual use and claims like auto insurance does.
Q. Does the athletics policy cover illnesses that may arise throughout the year?
A. Our athletic accident excess insurance coverage does not cover personal illnesses. We recommend that athletes purchase the university's student health insurance plan if they are not otherwise covered. The cost of the student insurance plancan be found on the Wright State University Student Health website. Benefits are payable for hospital charges, surgery charges, and for other covered medical expenses. A Certified Family Nurse Practitioner and Physician are available for primary health care in Student Health Services located in 051 Student Union for a fee. Should you have any questions regarding this coverage, please call Joyce Smith at (937) 775-2553. It is important to note that the STUDENT HEALTH INSURANCE COVERAGE DOES NOT COVER ATHLETIC INJURIES OR TRAUMAS.
Q. I have an HMO (or PPO) insurance policy. What do I need to do ensure proper coverage?
A. You must contact your insurance provider and ask if Wright State Orthopaedics and Sports Medicine is in network. If they are, you need not doing anything else. We will pre-certify (if needed) any tests that need to be completed, unless it is a medical emergency. If they are not in network, you must look to switch your PCP to Dr. Corey Ellis or obtain a referral from your family physician prior to being seen. Our insurance will not pay on a claim if it has not had any primary payment or if the primary insurance is still pending. Â
Q. My child was injured while at practice but did not tell anyone about their injury. He/She went to the emergency room on their own to have an x-ray done. Will these charges be covered by the Athletic Department?
A. Unfortunately not. We are not able to pay for any services rendered that are not directly referred by a member of the Sports Medicine Staff. Even in emergency situations, the Sports Medicine Staff needs to be informed.
Q. I filled out the Annual Insurance Form last year and our coverage has not changed. Do I need to update the information?
A. Yes you do. We must have updated insurance information and a copy of the insurance card (front and back) every year. Your child will not be allowed to participate without this! Our third party administrator will not be able to process claims that have not been closed out by your primary insurance and we need annual confirmation that the student is covered by useable health insurance.
Q. My insurance has changed (or will change) during the year. What should I do?
A. Please complete another Annual Insurance Form and attach a copy of the new insurance card. Then mail or fax to the Athletic Department Insurance Coordinator.
Adam Horseman
Wright State Physicians Building
Athletic Training Offices
725 University Boulevard
Dayton, Ohio 45435-0001
- Or fax to (937) 245-0736
Q. I just received a bill in the mail. What do I do now?
A. Forward the bill immediately to the Athletic Trainer / Insurance Coordinator. We will initiate the claim; however we will not be able to submit the claim without the Explanation of Benefits from your primary insurance.
Q. What is an Explanation of Benefits (EOB) and where do I get one?
A. The explanation of benefits is a statement from your primary insurance that explains how a bill from a provider was processed. It includes information like how much they paid, deductable and co pay amounts, and any network discounts. Most insurance carriers mail these to the member at the completion of the payment process. If you do not receive one, you will need contact your insurance carrier to request one.
