Insurance

Physical Forms

New/Transfer Student-Athlete Physical Form

TRAINING ROOM POLICIES AND PROCEDURES

All East Central University student-athletes, prospective student-athletes, student-coaches, student-athletic trainers, student-managers, pom squad members, and cheerleaders (from here on the entire list will be referred to as student-athlete) will be required to have primary medical insurance which will: 1) provide a minimum benefit of $2,500.00, 2) DOES NOT EXCLUDE intercollegiate athletic participation, and 3) approves medical coverage in the state of Oklahoma. Failure to have medical insurance will result in the student-athlete not being able to participate with their team; this includes mandatory and voluntary games, practices, and strength and conditioning workouts.

ECU’s policy carries a $2,500.00 per injury deductible which means that the “student-athlete’s” primary insurance company must make at least $2,500.00 in actual payments before ECU’s insurance policy will be activated. ECU strongly recommends that all “student-athletes” research and understand their insurance benefits prior to their arrival on campus. If the benefits from a “student-athlete’s” plan are insufficient or non-existent, such as an HMO or EPO, they may wish to call their carrier to inquire about alternatives. AFLAC is NOT a health insurance and is not acceptable as a primary insurance.

Every year proof of insurance must be provided to the ECU Athletic Training Staff prior to August 1st. This includes: 1) a photocopy of the front and back of the student-athlete’s current insurance card and 2) a completed ECU Insurance Form. Failure to provide this information will prevent the student-athlete from beginning and/or continuing participation with their team/organization.

The ECU Athletic Department carries a secondary, injury-only, medical insurance policy for each “student-athlete”. This secondary medical insurance policy ONLY covers athletically related musculoskeletal injuries and WILL NOT pay for illnesses. To be eligible for this secondary insurance, all “student-athletes” must meet the standards of an Official ECU Student-Athlete. This means all ‘student-athletes” must: 1)have completed all necessary paperwork and been cleared by the ECU Compliance Office for participation; 2)have completed all necessary physical paperwork and been cleared by the ECU Athletic Training Staff for participation; and 3)have verifiable proof of insurance on file with the ECU Athletic Training Staff. Secondary insurance coverage means that ECU will take responsibility for payment of medical services rendered to an injured ‘student-athlete”, only after the ‘student-athlete’s” personal insurance, which will always act as the primary insurance, has processed the claim.

ECU will only be responsible for musculoskeletal injuries that take place during scheduled official practices and/or games occurring during the normal school year unless the season is extended due to post-season participation. For cross country, football, soccer, and volleyball the first day of coverage begins on the first day of fall practice prior to the first day of school. Any injury occurring outside official practices and/or games or outside the normal school year will be the sole responsibility of the “student-athlete”; this includes summer workouts which are not considered official practices by the NCAA. ECU will only pay for musculoskeletal injuries or injuries that occur as a direct result of ECU athletic participation. ECU WILL NOT pay for injuries, musculoskeletal or otherwise, that are not directly related to athletic participation, this includes any and all medical ailments such as heart conditions. ECU WILL NOT pay for reoccurrences of previous injuries sustained prior to participation at ECU. Previous injuries include any injury, musculoskeletal or otherwise, that occurred prior to the “student-athlete” becoming an Official ECU Student-Athlete. ECU WILL NOT pay for any illnesses.

In order for ECU’s secondary insurance coverage to pay, care MUST FIRST be facilitated by the ECU Athletic Training Staff. If a “student-athlete” sees a physician or medical professional on their own, without prior notification and approval from an ECU Team Physician or the ECU Athletic Training Staff, ECU WILL NOT be responsible for payment of those medical services. “Student-athletes” are always more than welcome to get a second opinion; however, ECU WILL NOT be responsible for the cost of the second opinion. ECU WILL NOT pay for any costs that may result from the second opinion such as the initial visit, subsequent visits, medical treatments, and medical procedures such as surgeries. Prescriptions for medications are NOT covered by ECU.

Upon receipt of bills for authorized visits to a physician or hospital, the “student-athlete” must immediately bring those to the athletic training staff. This is a reminder for our staff to check the status of the claim, hopefully reducing the amount of processing time if additional information is required. Please understand that the filing process is very time consuming and may take 8-12 months before the claim is completely closed. Untimely delivery of bills to the athletic training staff will result in ECU no longer being responsible for payment of those particular bills.

There is a coverage gap for ECU insurance. All injuries must be resolved at the time of onset, which means that a “student-athlete” has 90 days from the date of the initial injury to have care administered. All arrangements for the care of a “student-athlete’s” injuries are to be made and taken care of prior to the “student-athlete” leaving ECU, either by graduation, personal choice, removal from the team, or otherwise. ECU WILL NOT be responsible for any medical costs once a “student-athlete” has departed ECU.

If a “student-athlete” belongs to an HMO or EPO, initial treatment may be delayed due to insurance complications. In order to minimize these delays, “student-athlete’ must locate a primary care physician near Ada, Oklahoma.

Any time a “student-athlete” is injured, during either an official competition or an official practice, there is a 3 stage insurance filing process. Stage 1) the medical insurance claims will be filed with the “student-athlete’s” personal insurance company, Stage 2)once proof of $2,500.00 in payments is available, the outstanding insurance claims will be filed with ECU’s secondary insurance company, Stage 3)any outstanding insurance claims will be addressed by ECU.

Guidelines
1.     ECU will only be responsible for injuries that take place during scheduled official competitions and/or countable activities occurring during the normal school year unless the season is extended due to post-season participation. For cross country, football, soccer, and volleyball the first day of coverage begins on the first day of fall practice prior to the first day of school. Any injury occurring outside official competitions and/or countable activities or outside the normal school year will be the sole responsibility of the “student-athlete”.

2.     It is the “student-athlete’s” responsibility to make sure that their personal insurance is current and up-to-date to prevent any delay in medical care. If for any reason a “student-athlete” is not insured (dropped from parents’ insurance, change of insurance, lapse in insurance, etc.), East Central University WILL NOT send the “student-athlete” to a medical provider until verification of insurance is provided to the ECU Athletic Training Staff.
Ø If the “student-athlete” requires emergency medical care, the cost of the medical care will be the responsibility of the “student-athlete.”

3.     The ECU secondary insurance source can only pay for musculoskeletal injuries and WILL NOT pay for illnesses or injuries not directly related to athletic participation.

4.     ECU WILL NOT pay for any medical care, doctor’s visits, medical interventions, or rehabilitation, relating to preexisting injuries. ECU WILL NOT be financially responsible for any medical care for re-injury of preexisting injuries.

5.     If ECU’s secondary carrier denies a claim stating that the injury was not precipitated by athletic participation, then ECU will take the same stance, and WILL NOT pay for any medical expenses occurred.

6.     “Student-athletes” must follow the guidelines of your primary insurance policy regardless if it is a HMO, EPO, PPO, or POS.

7.     Prescriptions for medications are not covered by ECU.

8.     Please be advised that all injuries must be reported to a staff athletic trainer. The ECU Athletic Training Staff will advise the “student-athlete” of the proper protocol that must be taken to insure proper payment by all insurance companies involved. At no time should the “student-athlete” seek medical treatment without the prior approval of the Athletic Trainer. This action will jeopardize and/or remove responsibility from ECU and its secondary insurance company for payment of medical bills.

9.     In order for ECU’s secondary insurance coverage to pay, care must be facilitated by the ECU Athletic Training Staff. If a “student-athlete” see a physician or medical professional on your own, without prior notification and approval from a team physician or the athletic training staff, ECU WILL NOT be responsible for payment of those medical services. “Student-athletes” are always more than welcome to get a second opinion; however, ECU “Student-athletes” be responsible for the cost of the visit or for subsequent treatment.

10. All itemized bills and EOB’s (Explanation of Benefits-from insurance company) for medical care should be immediately forwarded to the Head Athletic Trainer so that excess charges may be paid. This will help prevent the “student-athlete” and/or parents/guardians from being responsible for any out of pocket expenses or being sent to a collection agency. ECU WILL NOT be responsible for a “student-athlete” being turned over to collections if the medical bills were sent to the “student-athlete’s” home and never given to the ECU Athletic Training Staff.

11. All injuries must be resolved at the time of onset, which means that a “student-athlete” has 90 days from the date of the initial injury to have care administered. All medical care of a student-athlete’s injuries must occur prior to the “student-athlete” leaving ECU, either by graduation, withdraw, dismissal, or otherwise. ECU WILL NOT be responsible for any medical costs once a “student-athlete” has departed ECU.

12. It is the “student-athlete’s” responsibility to be cooperative, compliant, and provide the correct personal and insurance information about a medical claim to all hospitals, doctor’s offices, and collection agencies that contact them either by phone or mail. Failure to do so will result in ECU no longer being financially responsible for that medical claim.