Sports Medicine & Medical Insurance Policies. Samford University Department of Athletics

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1 Sports Medicine & Medical Insurance Policies Samford University Department of Athletics

2 Introduction: The Samford University Department of Athletics seeks to provide the highest quality health care to each of our student-athletes participating in our intercollegiate athletic program. With our well-qualified and highly trained medical and athletic training staffs, along with our excellent sports medicine facilities, we strive to keep our student-athletes free from athletic injuries and illnesses. While no one likes to think about injuries or illnesses, they are a possibility anytime an athlete participates in sports. For this reason you should be aware of Samford University s sports medicine and medical insurance policies. Insurance Coverage of Student-Athletes: The Samford University Department of Athletics requires that student-athletes provide a copy (front & back) of their medical/health insurance card prior to participating in any practice, game, and/or competition. Student-athletes are required to upload pictures of the front and back of their medical/health insurance card to the ATS Student-Athlete Portal on a yearly basis. The Samford University Department of Athletics, like most colleges and universities nationwide, carries EXCESS or SECONDARY insurance. The student- athlete s medical insurance will be considered the PRIMARY insurance coverage for all athletic related injuries. This means that all medical bills incurred by a student- athlete as a direct result of participation in intercollegiate athletics must first be filed with the student-athlete s or parent(s )/guardian(s ) primary health insurance. The student-athlete s injury: Must be a direct result of participation in the intercollegiate athletic program AND Must occur during the dates of the primary competitive season and designated offseasons as approved by the Director of Athletics according to NCAA regulations. Walk-on Student-athletes: Any walk-on student-athlete is REQUIRED to provide, prior to the first workout with the team, a proof of primary medical insurance which covers intercollegiate athletics. In addition, walk-on student-athletes will not be eligible for benefits paid by Samford University s secondary insurance company until the Samford University Athletic Compliance Officer verifies they are an official NCAA qualifier and are on the active squad list, for the team for which they are trying out. Any charges incurred as a result of an athletic injury before such status is achieved will be the responsibility of the student-athletes and/or International Student-Athletes: Samford University requires medical insurance coverage for all international students. Proof of insurance must be provided to Samford University. If you do not have health insurance, it can be purchased through the Samford University Department of Insurance & Risk Management by contacting: Mr. James A. Clement Director of Risk Management and Insurance Samford Hall 301 (205) Absence of Primary Insurance: In the event that a student-athlete does not have primary medical insurance and is financially unable to purchase medical insurance, he/she may apply for financial aid. The student-athlete s financial need will be determined by Samford University s Financial Aid Office. If financial need is established, the Samford University Department of Athletics will determine the ability to assume primary accident insurance on the student athlete for all injuries that occur as a result of participation in intercollegiate athletics at Samford University. Costs associated with any injury that is not a direct result of intercollegiate athletics participation at Samford University will be the responsibility of the student-athlete and/or his/her parent(s)/guardian(s)

3 Insurance Policy Changes: The Samford University Sports Medicine Staff MUST receive notice of any changes to the studentathlete s medical insurance policy, identification cards, etc. as soon as they are available. If proper notification is not received, the Samford University Athletics Department may not be responsible for any delays in payment, collections notices, credit reports, etc. that occur. Compliance with Insurance Company Requests: It is the student-athlete s and his/her parent(s )/guardian(s ) responsibility to understand the conditions that apply to their policy and comply with any requests for information, etc. from their primary medical insurance company. Any delinquent bills resulting in bad credit due to non-compliance with their insurance company s requests may be the responsibility of the student-athlete and /or his/her In the event that a student-athlete and/or his/her parent(s)/guardian(s) receive payment or reimbursement directly from their medical insurance company for athletic related injury claims, the full account balance becomes the responsibility of the student-athlete and/or his/her parent(s)/guardian(s) until payment is turned over to the medical provider. HMO/PPO: If a student-athlete s primary medical insurance coverage is through an HMO/PPO or other managed care, the Samford University Department of Athletics requests that the student-athlete, and/or his/her parent(s)/guardian(s) designate a primary care physician (PCP) in the Birmingham Metropolitan area. This PCP may be a Samford University Team Physician. This will allow the student-athlete to have a network of physicians in the immediate area, as well as avoid likely delays in receiving timely medical care for their athletic related injuries. You are strongly encouraged to provide us with specific instructions, requirements, and/or limitations which may be included with your medical insurance policy. Failure to follow the proper HMO/PPO procedures may void your eligibility for coverage under the athletic department's secondary insurance. Medical Bills: In the event that a student-athlete should receive a bill or statement for an injury that occurred as a direct result of participation in intercollegiate athletics at Samford University, the student-athlete must submit the bill to the Athletic Insurance Coordinator within 30 days of the statement date printed on the bill. Bills not received by the Insurance Coordinator within the designated time limit, may become the financial responsibility of the student-athlete and/or parents. The Samford University Athletics Department WILL NOT be responsible for any delays in payment, collections notices, credit reports, etc. that occur due to bill not being submitted in a timely manner. Submit all correspondence to: Brandon Evans, MAE, ATC Samford Athletics Head Athletic Trainer Samford University 800 Lakeshore Drive Birmingham, AL (205) Fax (205) Two Year Limitation on Secondary Insurance Coverage: The Samford University Department of Athletics medical and catastrophic insurance program will pay for the necessary medical treatment up to the usual and customary charges for such expenses incurred

4 within 104 weeks from the initial date of the injury. The first expense must be incurred within sixty calendar days of the injury. Exclusions and Limitations: The Samford University Department of Athletics secondary medical insurance policy WILL NOT apply to the situations indicated below. This list is not all-inclusive: Injuries that are not the direct result of intercollegiate athletics participation during the dates of the primary competitive season or during designated off-seasons as approved by the Director of Athletics based upon NCAA regulations. Experimental procedures. Cosmetic surgery or procedures unless a direct result of an intercollegiate athletics related injury. This does not include injuries exacerbated due to body piercing, jewelry, etc. Hospital room and board charges in excess of the semi-private room rate unless hospitalized in an intensive care unit. Injuries that are a result of intramural, club sports, and recreational activities (non-intercollegiate activities), as well as training/conditioning activities that occur outside of the primary competitive season and designated off-season periods. Injuries which were sustained before participation in the intercollegiate sports program and are not resolved prior to pre-participation physical exams. Expenses for athletic injuries incurred after completion of the student-athlete's intercollegiate athletic eligibility. Medical expenses beyond the limitations and exclusions of Samford University Department of Athletics insurance policy. The importance of having personal medical insurance coverage cannot be overemphasized. Medical bills resulting from the aforementioned activities will be submitted to the student-athlete's primary medical insurance. Any unpaid balances are the responsibility of the student-athlete and/or his/her The Master Policy on file at the University contains all of the provisions, limitations, exclusions, and qualifications of Samford University s Department of Athletics' insurance policy, some of which may not be included in this informational form. If any discrepancy exists between this form and the Policy, the Master Policy will govern and control the payment of benefits. Injury / Illness Reporting Procedures: Any student-athlete who is injured or becomes ill must report the injury/illness to a member of Samford University Athletic Training Staff as soon as possible. Costs pertaining to an injury and/or illness not reported in a timely manner (72 hours) may be the responsibility of the student-athlete and/or his/her Missed Doctors Appointments: Student-athletes who are late and/or fail to show-up for scheduled appointments with the team physician, medical consultants, for diagnostic tests or procedures will be financially responsible for any and all charges resulting from the missed appointment. In addition, the student-athlete will be responsible for rescheduling the appointment. "Out-of-town" Physical Therapy / Rehabilitation Procedures: At times, it may be necessary for a student-athlete to utilize an "out-of-town" physical therapy facility. In such situations, permission must be granted from the Samford University Athletic Training Staff. If a student-athlete decides to utilize physical therapy or rehabilitation services without prior authorization from a member of Samford University Athletic Training Staff, the student-athlete and/or the student athlete's parent(s) / guardian(s) will be financially responsible for any and all medical bills incurred. Physician Referrals / Consultations: The Samford University Department of Athletics and the Sports Medicine Staff have fostered positive relationships with many medical providers in the Birmingham, Al metropolitan area who have consistently provided high quality service to Samford University student-athletes. Members of the Samford University Sports Medicine Staff will refer student-athletes to these providers, unless extenuating circumstances necessitate a different provider. Student-athletes with HMO/PPO policies are strongly encouraged to have a local primary care physician (PCP), so that timely care can be given.

5 All student-athletes must be seen and evaluated by a member of the Samford University Sports Medicine Staff before a referral to a physician will be made. A member of the Samford University Sports Medicine Staff must provide written authorization and properly refer all student-athletes to see a physician or medical consultant, for diagnostic tests. If a student-athlete decides to see a physician/medical consultant, or undergo a diagnostic test WITHOUT the written referral from a member of the Samford University Athletic Training Staff, the student-athlete and/or the student athlete's parent(s)/guardian(s) will be financially responsible for any and all medical bills incurred. Orthopedic and/or Medical Second Opinions: If a student-athlete and/or his/her parent(s)/guardian(s) desire another physician's opinion on an orthopedic and/or medical injury, a member of the Samford University Athletic Training Staff will make arrangements for the second opinion with a qualified local physician. If a student-athlete decides to see a physician without the written authorization from a member of the Samford University Athletic Training Staff, the student-athlete and/or the student athlete's parent(s)/guardian(s) will be financially responsible for any and all medical bills incurred. NCAA Catastrophic Insurance Program: The NCAA sponsors a Catastrophic Injury Insurance Program which covers the student-athlete who is catastrophically injured while participating in a covered intercollegiate athletic activity. The policy has a $75,000 deductible (which will be covered by the Samford University Athletic Insurance Basic Policy) and will and provide benefits in excess of any other valid and collectible insurance. For more information, refer to the NCAA web site at Dental Care: The Samford University Department of Athletics medical insurance program will assume financial responsibility for dental care resulting from the direct participation in the intercollegiate athletics program as approved by the Director of Athletics according to NCAA regulations. As with other injuries, this insurance is SECONDARY to, or in excess of, personal family medical insurance coverage. The Samford University Department of Athletics and its medical and catastrophic insurance program WILL NOT assume financial responsibility for dental injuries, head and facial injuries, and/or mild traumatic brain injuries (concussions) if the student-athlete is not properly wearing his/her required mouthpiece at the time of injury. Medical bills associated with such injuries will be the sole responsibility of the student-athlete and/or his/her parent(s) / guardian(s). Pharmacy: All prescription requests must be authorized by a member of the Samford University Athletic Training Staff. Any unauthorized prescriptions will not be paid for by the Samford University Department of Athletics. "After-Hours" Emergencies: In case of an "after-hours" emergency, student-athletes should contact Samford University Public Safety & Emergency Management at or proceed immediately to St. Vincent s Hospital Emergency Room (phone: ). Student-athletes should call and/or have someone else call a member of the Samford University Sports Medicine staff as soon as possible. Return to Play Policy: A Samford University Team Physician or his/her designee, in consultation with a Samford University certified athletic trainer, has the final authority in deciding if and when an injured student-athlete may return to practice or competition. A student-athlete's private physician DOES NOT have any jurisdiction as to the participation status of the student-athlete. Any student-athlete seen by a physician other than the Samford University Team Physician must return to the athletic training room for follow-up and final clearance prior to active participation status. If a student-athlete is under the care of a private physician for an injury or illness and the physician's treatment precludes or alters activity in intercollegiate athletics, the student-athlete must secure, in writing, a release to reinstate the student-athlete to full participation. No student-athlete will be allowed to return to participation until the Samford University Sports Medicine Staff has received a release from the treating physician AND is cleared by a Samford University Team Physician or designee.

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