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Keep this information pamphlet for reference throughout your child’s career at Liberty. We are willing to advise you through these procedures. Should you have any questions, or if problems develop in the claims process, please feel free to contact the Sports Medicine Insurance Coordinator at (434) 592-4696. Thank you for your cooperation.

*This summary is information only, and is subject to the term/conditions of the applicable insurance policy.

LU Athletic Insurance Policy

Liberty University Insurance and Injury Procedures

This pamphlet is provided to help explain our sports medicine procedures for injuries, athletic insurance policies, and the injury referral process. We also hope this pamphlet will provide answers to any questions you may have regarding our policies, procedures, and insurance coverage.

In order to provide the best possible health care for our student-athletes, continuity of care amongst the entire Sports Medicine Network is essential from the time of the injury through complete rehabilitation. We work closely with the Student Health Center: Dr.’s  Richard Lane and Mike Hueber; Orthopaedic Center of Central Virginia: Dr.’s John Prahinski and Michael Diminick; and with other members of the local community who comprise our Sports Medicine Network. This network was formed to ensure accurate and continuous communication between the physician and the sports medicine staff concerning our athletes’ care. Your cooperation in adhering to the policies and procedures outlined in this pamphlet will enhance this care and is a necessity in order to make claims through our secondary athletic insurance plan.

What type of athletic insurance does the athletic department carry?

To help defray the cost to the parent or guardian, and as a service to our student-athletes, Liberty University carries a secondary or supplemental athletic accident insurance policy. The secondary policy may be applied to medical costs incurred for medical services rendered for athletic injuries that are a direct result of intercollegiate activity which occur during a coach supervised and sanctioned; workout, practice, or competition. These medical services must be coordinated by the sports medicine staff.

This insurance policy requires that the injured athlete first make a claim under his/her parents’ or guardians’ primary medical or hospitalization insurance. Medical expenses not covered under the primary insurance will be submitted under the university’s policy subject to its limitations and conditions. Although we attempt to purchase the most comprehensive policy within our resources, this is not an all-inclusive policy. A student-athlete is not covered under the university’s secondary policy until the student-athlete has been “medically certified” by the sports medicine department. All student-athletes must be medically certified prior to any athletic participation. (Please see “medical certification” below). Scholarship athletes without any primary insurance are covered by our secondary policy for athletic injuries (only), providing they are medically certified. Student-athletes must indicate that they have no personal insurance PRIOR to participation, and must also follow proper referral procedures. It is strongly recommended that all student-athletes carry personal medical insurance as the secondary athletic insurance only covers injuries that are sustained while participating in a coach supervised workout, practice or competition. Student-athletes who drop their medical insurance and do not notify the sports medicine staff within one week of dropping their insurance may not be eligible for secondary coverage. Also, any medical procedure that is delayed by the student-athlete and their personal insurance lapses during that time may jeopardize Liberty’s secondary coverage.

How do I qualify for secondary coverage?

Any student-athlete who is on the official team roster, has been medically cleared to participate, and has completed all required medical documentation is eligible for secondary coverage for a sports related injury.

How does the insurance coverage work?

The insurance policy requires that the injured athlete first make a claim under his/her primary medical or hospitalization insurance. When an athlete is referred for care for an athletic injury, the athlete is responsible for providing Liberty’s medical provider his/her primary insurance information. Liberty’s provider will then file a claim with the student-athlete’s insurance company for the services rendered. The primary provider will evaluate the claim and either pay or deny the claim. The provider may also send the parent or guardian a bill to file with their primary insurance company.

If after 30 days from the date of the services rendered, you have not received anything from your insurance company, call your insurance company to check on the status of the claim or resubmit the bill from the provider to your insurance company.

When you receive an Explanation or Benefits or payment denial from your insurance company concerning the claim, please forward a copy directly to Bob McCloskey Insurance:

BMI, L.L.C.
Attention: Heather O'Keefe
PO Box 511, 76 Main St.
Matawan, NJ 07747
ph: (800) 445-3126
fax: (731) 583-9610
heather@bobmccloskey.com

BMI Benefits cannot submit any claims until they have a copy of the Explanation of Benefits and matching bills. It is the student-athlete’s or parent’/guardians’ responsibility to send this information to BMI Benefits as soon as possible. The claim must be submitted within 90 days of the date of injury, so your attention to this matter is very important. If 90 days elapse without a claim being made to the secondary insurance, the financial responsibility will be placed on the student-athletes’ or parents’/guardians’. If the student-athlete’s or parent’s/guardians’ insurance company sends you a check for payment of a bill, it is your responsibility to forward that payment to the medical provider listed on the Explanation of Benefits.

When is a student-athlete referred to a physician?

Whenever the athletic trainers are of the opinion that a referral or consultation would enhance the care of the athletic injury, arrangement for such a visit will be made by the Sports Medicine staff with a participant in our Sports Medicine Network. Coaches do not have the authority to refer an athlete to any physician except for emergency medical care, and only in the case where a sports medicine staff member is unavailable.

What if my insurance company is an HMO or PPO?

If a student-athlete and/or parents or guardians belong to a Health Maintenance Organization or a Preferred Provider Organization, you are limited to the HMO’s or PPO’s physicians and facilities. You are requested to send requirements and/or limitations which may be included within the policy, and/or affect the coverage. This information is necessary for the claims process to be filed correctly.

The student-athlete and/or parent or guardian is responsible for making the Sports Medicine staff aware of requirements or limitations in their coverage and the proper procedures that must be followed. Failure to follow proper procedures through the HMO/PPO coverage may void a student-athlete’s eligibility for coverage under the university secondary insurance; making the student-athlete and parent or guardian financially responsible for all medical bills.

Which physicians can an athlete see under this insurance plan?

For an athlete to be best served under the university’s secondary insurance, they must be seen by a participant in our Sports Medicine Network. If an athlete wishes to seek other medical attention outside of our Sports Medicine Network, prior authorization must be obtained from one of our team physicians.

If an athlete seeks a second opinion or care from an out-of-network physician, he/she will be medically ineligible to participate in athletics, or to utilize the services of the Liberty University Sports Medicine Department until medical records are received and reviewed by university’s Sports Medicine staff. The athlete has the responsibility to ensure the physician forwards all requested information. The student-athlete will also assume the financial responsibility for any travel costs and the services of the physician. Liberty’s secondary insurance coverage will not be applied to those services.

To which bills can the secondary insurance coverage be applied?

The university’s secondary insurance can be applied only to those bills:

1. For which athletic related injuries/illnesses were serviced by participants in Liberty’s Sports Medicine Network.
2. When prior written approval for a referral was granted through the sports medicine staff.
3. When the care has been coordinated through the athletic training staff.
4. For care rendered within 1 year of the date of injury.
5. The student-athlete’s insurance company has responded to and resolved all claims.

What types of things are NOT covered under the secondary insurance policy?

1. An injury sustained in an activity which is not associated with a required intercollegiate practice or competition supervised by a coach.
2. Any pre-existing condition that has not resolved. Keep in mind that while clearance for full participation may be granted by our medical staff for pre-existing injuries and/or medical conditions, these injuries are not necessarily classified as resolved. Any further or continued issue related to a pre-existing condition is not covered under the Liberty University’s secondary insurance policy.
3. Any pre-existing degenerative condition diagnosed by a physician.
4. Any illness (cold, flu, infection, appendicitis, etc.) which is not considered an athletic injury as well as any prescription medications for any such illnesses.
5. Unauthorized consultations or treatments.
6. Conditions as a result of noncompliance with the school’s policies, team rules, or the advice of the team physician, attending physician, or the athletic trainer.
7. Any injury that has not been reported to and evaluated by the athletic trainers within 7 days of occurrence or the onset of symptoms.
8. Chiropractic care, podiatry care, massage therapy, etc. that has not been recommended or referred through the Liberty University Sports Medicine Department.
9. Any cost that may be charged to an athlete due to the fact they were a “no show” for an appointment.

What are the parent’/guardians and/or student-athletes responsibilities?

The first responsibility of the athlete is to report and have the injury evaluated by a staff athletic trainer within 7 days of occurrence or the onset of symptoms. Failure to do this will jeopardize reporting the claim to the secondary insurance company. This can negate any financial responsibility of the secondary insurance and make the student-athlete and/or parent/guardian responsible for all medical bills.

If during the course of the school year the parent/guardians’ insurance coverage changes in any way, it is their responsibility to notify the Sports Medicine Department of any and all changes. Failure to do this will place all financial responsibility on the student-athlete and/or parent/guardian. It must be clearly understood that the student-athlete and his/her parent or guardian are financially responsible for all charges for services rendered for the care of an athletic injury and the resolution of all insurance claims. THE ATHLETICS DEPARTMENT AT LIBERTY UNIVERSITY DOES NOT ASSUME ANY LIABILITY FOR EXPENSES GENERATED FROM THE MEDICAL CARE OF ANY ATHLETE. Liberty carries a secondary insurance coverage as a service to our athletes, in an attempt to relieve any financial burden that may occur from the care of athletic injuries. However, this is not an all-inclusive policy, and benefits will be applied to the terms and limitations of the policy.

How do student-athletes become “medically certified”?

The following requirements must be met before any student-athlete is considered medically certified and is cleared to participate in athletics at Liberty University.

Scholarship Athletes:

1. The athlete must receive a physical examination by Liberty’s physicians in our Sports Medicine Network initially and complete a follow-up medical history with the sports medicine staff annually. All student athletes must show the results of a sickle cell trait test.

2. All medical forms must be completed and on file in the Sports Medicine Department. This includes: all insurance information including a copy, front and back, of the athlete’s insurance card; assumption of risk; medical authorization; and a disclosure of protected health information. These forms must be completed annually.

If willful participation by any student-athlete occurs without completion of the above requirements, the secondary insurance and Liberty University Athletics Department is automatically relieved of any financial responsibility for any medical bills that may arise.

Non Scholarship / Walk-On Student Athletes:

1. The athlete must receive a physical examination by Liberty’s physicians in our Sports Medicine Network initially and complete a follow-up medical history with the sports medicine staff annually. All student athletes must show the results of a sickle cell trait test.

2. All medical forms must be completed and on file in the Sports Medicine Department. This includes: all insurance information including a copy, front and back, of the athlete’s insurance card; assumption of risk; medical authorization; and a disclosure of protected health information. These forms must be completed annually.

3. Show Proof of Primary Health Insurance that covers athletic injuries. Coverage must have a deductable of no greater than $1,000.00 and have out of network benefits in the state of Virginia.