Sports Medicine

Sports Medicine Insurance Information and Medical Billing Policies

Sports Medicine Insurance Information
In order to provide the best possible care, it is critical that the insurance information form be completed entirely. This form must be completed regardless of whether the student-athlete is covered under a family health insurance plan. The insurance form is also used for emergency contact information, so it is imperative that the form be complete and up-to-date. This form and a new copy of the insurance card (front and back) must be submitted every year even if there are no changes to the insurance information. The Department of Sports Medicine must be notified immediately if any changes occur in the insurance coverage or if the home address changes.

If an insurance form is incomplete or not submitted, payment for medical bills will be the student-athlete/family's responsibility. In addition, to help expedite care, the Department of Sports Medicine requires a photocopy of additional health-related insurance cards (prescription drug cards, dental, vision).

In the event that a student-athlete receives medical care while at DePaul, at times medical bills will be sent to the home address of the student-athlete; however, the majority of medical bills are sent to the Department of Sports Medicine. It is the responsibility of the policyholder that medical claims be submitted to the primary insurance company for processing. DePaul acts as a secondary insurance provider for student-athletes. Claims or the portions of claims to be paid by DePaul cannot be processed until an Explanation of Benefits statement or a Denial is received from the policyholder or the insurance company stating the amount covered by the primary insurance company. In addition, it is the policyholder's responsibility to obtain pre-authorization for services to be provided out of the health insurance network.

Medical Billing Policies/Insurance Information
1. Every DePaul student-athlete will have two confidentially protected medical files in the Department of Sports Medicine training facility (HIPAA and FERPA). These files will not leave the training facility and will be in restricted area access at all times.

2. Staff members of the Department of Sports Medicine will act as insurance coordinators for student-athletes. This staff will be limited to a maximum of three people per year.

3. DePaul University uses Cigna as our secondary insurance carrier for student-athletes who do not have primary insurance, and for medical expenses not covered by a student's primary insurance carrier.

4. Documentation of all medical services, payment of bills, and submissions to the DePaul insurance carrier shall be maintained and recorded in the student-athlete's secured medical file.

5. The procedure for submission and payment of medical bills is as follows:
a. A medical bill must first be submitted to the student-athlete's primary insurance carrier (if one is provided).
b. If the primary insurance carrier refuses payment or does not cover the complete bill, an Explanation of Benefits (EOB) or Denial must be submitted to the insurance carrier.
c. If a student-athlete does not have a primary insurance carrier, DePaul's carrier will cover medical expenses. DePaul also will cover medical expenses, in accordance with above that are under the Cigna deductible.
d. When a bill is ready to be submitted for payment, the DePaul insurance coordinator shall review it, complete a medical payment form and forward it to the DePaul business manager for payment.
e. Each bill's payment status is documented in the computer on a spreadsheet that is not networked with any other computer for privacy and confidentiality purposes.

6. DePaul University is not responsible for any missed or non-canceled appointments that incur cancellation fees.

7. Parents are responsible for keeping primary insurance updated of student athletes' full-time student status. If this is not updated and current, primary coverage can be lost and insurance claims can be denied.



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