UNIVERSITY OF TOLEDO SPORTS MEDICINE POLICIES AND PROCEDURES

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1 1 UNIVERSITY OF TOLEDO SPORTS MEDICINE POLICIES AND PROCEDURES 1. Athletic Insurance Coverage. Revised 2009 Insurance coverage for any injury sustained while participating in an intercollegiate sport at The University of Toledo is a secondary accident policy. Participation is defined as periods of official, organized athletic participation while under the general supervision of authorized University personnel or outside practice in preparation for intercollegiate participation. Parental or guardian insurance is the primary coverage. This means that the medical provider will send medical bills incurred, as the result of injury in an intercollegiate sport, directly to the primary company or the athlete s home address. The University of Toledo policy will be secondary, thus assisting in the remainder of the medical bill after the primary coverage has responded. This is only the case when the injury is sustained during participation in practice or contest of an athlete s given sport. CLAIM PROCEDURE Submit any bill received concerning the injury to the individual or employer group coverage. The insurance company will do one of two things: 1. The insurance carrier will honor the claim and pay all or a portion of the bills. If there is a balance after your insurance has contributed, send or mail the claim sheet or explanation of benefits (EOB) from the insurance company along with a copy of the itemized bills to The University of Toledo Athletic Injury Insurance Coordinator. The address is: Michelle Harris Athletic Insurance Coordinator Savage Arena 2801 West Bancroft St. Toledo, OH (419) If the insurance carrier will not honor the claim and send you a letter of denial. When this happens, send the denial letter and a copy of the itemized bills to Athletic Insurance Coordinator at the above address. ***If you do not have insurance coverage**** It is The University of Toledo's policy that ALL students have primary insurance. Should a student-athlete state they do not have insurance coverage, they will be added to the school's primary insurance policy and the student-athlete will be responsible for paying for the coverage. If parents or student-athlete refuse to give primary insurance information or if false information is provided then The University of Toledo will not be responsible for any medical bills incurred as a result of participation in intercollegiate athletics. The Athletic Department Insurance is a secondary policy. We cannot be held liable for expenses associated with non-participation related examination or testing. THE ATHLETIC TRAINING STAFF MAY ASSIST THE STUDENT-ATHLETE BY MAKING NON-PARTICIPATION RELATED

2 2 APPOINTMENTS. HOWEVER, IT SHOULD NOT BE ASSUMED THE ATHLETIC DEPARTMENT WILL COVER THE EXPENSES FOR SUCH APPOINTMENTS. Claims for The University of Toledo secondary coverage must be submitted within one year of the injury date. Failure to present bills to the Athletic Department will result in refusal of The University of Toledo secondary coverage to pay. This is written as a one-year term policy. You must turn the medical bills in as soon as your primary policy has responded. We will do our best to assist you throughout the insurance claim process. However, the athlete (and the parent or guardian) is ultimately responsible for communicating with your insurance company on the status of a medical claim. ***IMPORTANT NOTICE*** The insurance information form must be completed and signed by the athlete, parent, or spouse. Please return the form to the athletic department using the enclosed envelope. Be sure to fill-in all the necessary blanks including the policy numbers, address, and phone number of the insurance carrier and include a copy of your insurance card and prescription card. If the health insurance coverage is with a HMO/PPO, please indicate that on the form. The HMO/PPO programs have authorized medical vendors that must be used. We are required to use these plans as the primary insurance. The Athletic Department s secondary coverage will not pay for bills that are payable by other insurance carriers or plans. 2. Pre-Participation Examination. A. Freshman and Transfer Students. First time participants and/or transfer students must undergo a physical examination prior to their participation in intercollegiate athletics. The pre-participation examination must be completed before organized participation (practice) begins and must be completed by a University of Toledo Team Physician. B. Upper-Class Students. Athletes returning from the previous season must undergo an Annual Health Appraisal, otherwise known as a physical update. A Certified Athletic Trainer will do the appraisal and will be reviewed by a University of Toledo Team Physician. Any identified problems will be referred to either the Team Physician or the Student Medical Center at the University of Toledo. Any athlete that has been out of collegiate competition for a year must undergo a complete physical examination prior to participation. C. If an athlete misses their scheduled physical or their Annual Health Appraisal, it is their responsibility to see a member of the sports medicine staff to re-schedule a time for these exams. There will be a $25.00 fee for all late physical examinations and a $15.00 fee for late Annual Health Appraisals. D. Auditions/Try-Outs. The Athletic Department will not be responsible for an injury that may occur during an audition or tryout prior to the pre-season physical examination. A release and waiver must be signed before any athlete can participate in an audition or try-out. A student wishing to try-out for a team must also provide proof primary medical insurance and a physical from a physician within the past six (6) months.

3 3. Injury/Illness Evaluation and Treatment. 3 An injury or illness sustained during in-season supervised practice or contest must be reported as soon as possible to the Sports Medicine Staff. An athletic trainer will do a primary evaluation. If the trauma or illness is beyond the athletic trainer s level of care, the athlete will then be referred to one of our team physicians or the University of Toledo Medical Center. A program of treatment and management will be prescribed. It is the athlete s responsibility to schedule treatment and rehabilitation in the morning, before team practices begin in the afternoon. All treatments and rehabilitation must be done before 11:30 AM. The Sports Medicine Staff cannot be held liable if the athlete does not comply with the program that is prescribed. The decision to return to athletic participation will be made by the Sports Medicine Staff. 4. Referral and Outside Consultation. The University of Toledo Team Physician may determine that further evaluation is needed in the treatment of an injury. Appointments for such referrals will be made by one of the University of Toledo Certified Athletic Trainers. Any unauthorized referral will be the sole responsibility of the athlete involved. If the athlete, their parents or guardian, spouse and/or coach seek outside care of any injury, the Athletic Department is not financially responsible for any and all charges pertaining to the unauthorized referral. The athlete will not be permitted to participate, after outside consultation, until: 1) a detailed written report has been received from the consulting physician; 2) an evaluation is made by the Sports Medicine Staff, and it has been determined that the athlete can demonstrate the necessary skills needed to resume participation. Should an athlete request a Second Opinion, The University of Toledo will follow the Insurance Guidelines stated above, provided a member of The University of Toledo Sports Medicine Staff sets up the referral. Any outside Second Opinions not authorized by The University of Toledo Sports Medicine Staff will not be covered under The University of Toledo s Secondary Insurance Policy! 5. Medical Disqualification. The University of Toledo Sports Medicine Staff and Team Physicians reserve the right to Medically Disqualify a student athlete under NCAA rules. If it has been medically determined that it is unsafe or detrimental to their long-term health of a student athlete to continue participation in Intercollegiate Athletics, the Head Team Physician has ultimate authority to Medically Disqualify a student athlete from participation. 6. Dental Injuries. It is highly suggested athletes participating in contact sports wear a mouth guard during practice and contests. Contact sports are men s and women s basketball. Athletes participating in the sport of football are required to wear a mouth guard during practice and competition. The Athletic Department is not financially responsible for any damage that results from failure to wear a mouth guard. Mouth guards are available in the Athletic Training Rooms at the Larimer and Savage Hall complexes. 7. Corrective Lenses. The repair of glasses or the replacement of contact lenses will be provided by the Athletic Department if damage or loss was the result of participation during in-season, supervised practice or contests. The damage or loss must be reported immediately. All athletes who wear glasses are required to wear safety frames and lenses. The Athletic Department is not responsible for lost contact lenses outside of supervised in-season participation.

4 8. Illness. 4 Should a student athlete become sick at any time during the year, they are to immediately report their illness to a member of The University of Toledo Sports Medicine Staff. A Staff Member will review their condition and determine the appropriate referral. The University of Toledo s Secondary Insurance Policy does not cover illness (cold, flu, gastro-intestinal illness, etc.) 9. Termination of Participation. The University of Toledo is no longer responsible for the care of an injury once an athlete completes their eligibility or has made a decision to no longer participate as a varsity athlete. This statement holds true unless arrangements have been made prior to the time of termination regarding the care of an injury. 10. Pregnant Athlete. A varsity athlete must report her pregnancy to a Team Physician as soon as possible to eliminate any health risks to both the mother and the fetus. All information pertaining to the pregnancy will be treated as a physician and patient confidential transaction. The athlete, her personal physician, and the University of Toledo Team Physician will weigh the danger of athletic participation. If the decision is made to allow the pregnant athlete to participate, a document of understanding and waiver must be signed. 11. Pre-Existing Medical Condition(s)/Injury. Any or all pre-existing injuries or medical conditions must be reported and documented to the University of Toledo Sports Medicine Team. This must be done prior to, or at the time of the initial physical examination. The University of Toledo will not be financially responsible for any bills that are generated by a pre-existing condition. 12. Body Piercing. Any body piercing (i.e. ears, nose, tongue, eyebrow, etc ) may not be worn during participation of intercollegiate athletics at The University of Toledo. Any injury resulting from wearing a piercing is the sole responsibility of the athlete. 13. Nutritional Supplements. The University of Toledo Sports Medicine Staff discourages the use of any/all nutritional supplements. If you choose to take a supplement, you acknowledge the risk of losing your eligibility to participate in intercollegiate athletics if you test positive for an NCAA banned substance that may be found in any substance that you may take, regardless of the reason or purpose for taking such supplements. You will be asked to fill-out a form and disclose all consumed nutritional supplements during your first Athletic Department Team meeting. 14. Drug Testing The University of Toledo Athletic Department requires that all athletes read and sign the institutional drug testing policy. All athletes are subject to random drug screens.

5 15. Athletic Training Room Rules 5 1. NO cell phones in the athletic training room 2. No food in the athletic training room 3. No shoes on the treatment tables 4. No loitering in the athletic training room 5. Keep all scheduled appointments

6 Acknowledgement of The University of Toledo Sports Medicine Policies and Procedures 6 I have read and understand The University of Toledo Sports Medicine Policies and Procedures. Print Parent s Name Parent s Signature Date Print Parent s Name Parent s Signature Date Print Athlete s Name Athlete s Signature Date Remember.your son/daughter CANNOT PARTICIPATE in any team related activity until this form has been completed and returned to our office.

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