Hokie ClubThe goal of the Athletics Department is to provide the best health care delivery system for student-athletes at Virginia Tech. Communication and cooperation from the attending physicians and the athletic trainers from the initial time of injury through the process of rehabilitation is essential. The information in this pamphlet will explain the insurance policy of the Athletics Department, referral procedures and procedures for filing insurance claims.
The Athletics Department has purchased a secondary insurance policy for student-athletes. The policy will be applied to medical costs incurred for services rendered by authorized health care providers. The Department's policy is not all-inclusive.
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 student athlete's annual physical exam.
How does the Department's insurance policy work?
Virginia Tech'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 company will evaluate and whether 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 Insurance Coordinator.
All claims must be resolved within 2 years (104 weeks) from the date of injury.
Which physicians can a student-athlete utilize under this plan?
The physicians and health care providers utilized by the Athletics Department are a wide range of nationally known specialists. The Athletics Department primary care physicians are the "Gatekeepers" of the student athletes health care plan. It is the department's primary care physician who coordinates the referral of all student athletes. All referrals for medical care outside the campus sports medicine facility must be issued by the team physician. New River Valley Orthopedics provides our orthopedic physician, and Montgomery Regional Hospital is the medical facility of choice. The relationship between the Athletics Department and the network of physicians insures efficient communication between the physicians and the athletic training staff.
Second opinions
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 if NOT covered under VT's insurance policy?
-Injury or illness sustained in an activity that is not associated with required intercollegiate practice or competition supervised by a coach.
-Unauthorized consultations or treatments.
-New injuries or illnesses that occur after the student-athletes eligibility is exhausted.
-Medical costs after the student athlete's eligibility is exhausted.
REMEMBER
-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.
-You should hear from your insurance company within 45 days from the time of service.
CALL FOR HELP
The Athletics Department's Medical Clerk/Insurance Assistant
Grace Wilder
Eddie Ferrell Athletic Training Room
160 Jamerson Center (0502)
510 Stadium Rd
Blacksburg, VA 24061
(540) 232-8453
gracew22@vt.edu