PRIVACY AND CONFIDENTIALITY
All medical care and counseling at Rutgers Sports Medicine is confidential and protected by Federal/State privacy laws. For a full description of how your health information may be used or disclosed, please refer to the Notice of Privacy Practices in the Forms section.
STUDENT INSURANCE COVERAGENew Jersey law requires that all full-time students who attend state colleges and universities have health insurance. Students who do not have personal health insurance are billed for the Rutgers University student insurance plan on their term bill when they register for classes. This coverage can be used for illness, non-athletic injury, and prescription. Full-time students already covered by a health insurance plan will not need to purchase additional insurance. Students are required to provide their insurance information through a pre-enrollment verification process or through the insurance verification form that will be sent by the Registrar’s office. Full-time and part-time student-athletes who do not have health insurance must select an insurance plan offered through a national provider with whom Rutgers has contracted to provide low-cost health insurance. The cost of the selected plan will be added to the student’s term bill. Other health insurance plans that provide greater coverage will be available to students as options for higher premium rates. Student-athletes on an active roster will also have coverage through the athletic insurance plan (see Athletic Insurance section below).Any significant change in a student-athlete’s health plan (i.e., plan change or plan termination) must be reported to the Sports Medicine office as well as the Student Accounting Financial office. For additional information about the student insurance plan, please contact the student insurance office at 848-932-8285 or 848-932-7401/7402.
ATHLETIC INSURANCE COVERAGE
Intercollegiate Athletic Insurance coverage is for injuries sustained during supervised practice, contests, or travel. The insurance is “excess type" coverage. It provides coverage for athletic injury only. It will not cover illness or non-athletic injury. All claims must first be submitted to your parent's or guardian’s insurance company for payment. Our insurance carrier will then pay any unpaid portion of the bill within the limits of the policy. No outside treatment is covered by our insurance plan without referral by our team physician. . For further information, contact the Athletic Insurance Coordinator, located in the Sports Medicine Office at (732) 445-6261.
In-network providers will be paid at 100%. Out-of-network providers will be paid at the reasonable and customary rate. The reasonable and customary rate is the maximum allowance the insurance carrier will consider for the service rendered. If an out-of-network provider is used, Rutgers University will not be responsible for paying any balance that exceeds the reasonable and customary rate, even if the injury occurred at Rutgers or the team physician referred the athlete to an out-of-network provider.
Bills for non-athletic injury or illness are submitted through the student’s personal insurance. If the student does not have personal insurance, he/she must purchase coverage through the Rutgers University Student Insurance office (see Student Insurance section above). ).
If you are enrolled in summer sessions and utilize the Health Services, a summer “fee” will be charged to the student-athlete. For information on the summer fee please contact the Student Insurance office. A fee will not be charged if you utilize the Sports Medicine office located at the Hale Center. This service is for student-athletes only.
MEDICAL BILLS / INSURANCE PROCEDURES
Injury Claim Form:
- All injuries must be documented with an Injury Claim Form. This form may be filled out by any athletic trainer, team physician, or coach.
- All injuries must be reported to an athletic trainer, medical staff member or coach within 72 hours of the injury. If you do not report the injury you will be held responsible for any expenses incurred as a result of treating the injury.
For those who have personal primary and/or secondary insurance:
- Medical bills should first be sent to your primary and/or secondary insurance carrier
- Your primary and/or secondary insurance carrier will send you an Explanation of Benefits (EOB) for the medical services provided. Even if there is a denial of benefits, your primary and/or secondary insurance carrier will send you a denial Explanation of Benefits (EOB).
- If there is a remaining balance after the medical bill has been sent to your primary and/or secondary insurance carrier, the bill and the EOB from your insurance carrier should be sent to the Rutgers University Sports Medicine office (see contact information listed below).
- Our office will then submit the medical bill and the EOB for balance payment that is within the limits of the athletic insurance policy. The medical bill must be submitted for claim within 90 days after the injury has occurred or as soon as reasonably possible.
For those who do not have personal insurance:
- The medical provider should submit the bill to the Rutgers University Sports Medicine office (see contact information listed below).
- Our office will then submit the medical bill for payment that is within the limits of the athletic insurance policy. The medical bill must be submitted for claim within 90 days after the injury has occurred or as soon as reasonably possible.
Claims can be faxed to 732-445-2780 (alternate fax 732-445-3462) or mailed to Rutgers University, Hale Center, Attn: Athletic Insurance, One Scarlet Knight Way, Piscataway, NJ 08854.
BILLING: PERSONAL INSURANCE
Rutgers University will bill student-athletes’ personal primary and/or personal secondary medical insurance companies for medical treatments/problems. The student-athletes/parents’ insurance company will be billed for medical treatment that Rutgers University Sports Medicine supplies to the student-athlete. Student-athletes/parents should not receive a bill from the medical provider for these services, however they may receive an Explanation of Benefits (EOB) from their insurance company for these services, describing medical bills that were sent to them. Student-athletes/parents will not be asked to personally pay money for the student-athlete’s care when their insurance is billed by the Sports Medicine office. Medical care for student-athletes is handled through the Hale Center at Rutgers University. Student-athletes must supply the Sports Medicine office with a copy of their current insurance card as well as maintain current insurance information.
RESPONSIBILITIES OF STUDENT-ATHLETES
Student athletes are expected to be aware of and comply with the requirements described above. If you sustain an injury during a supervised practice or competition, or during travel, report to an athletic training room for an evaluation. Should your medical problem require further testing or generate medical bills, then feel free to discuss them with the athletic insurance office located in the Sports Medicine Office. The athletic insurance office can help familiarize you with the claims process or check on the status of pending claims.
It must be understood by student-athletes and their families that medical expenses are not “automatically taken care of” by the athletic department or the university. Athletic scholarships do not cover medical expenses. Your medical expenses are “real world” debts and you are responsible for ensuring their settlements. Paying athletic related medical expenses requires cooperation of the student-athlete and his/her family and coordination between various offices and departments in and around the Rutgers’ community. The ongoing responsibility and cooperation of student-athletes and their families are both necessary and expected.
Student-athletes are expected to understand that if they receive medical bills they should be presented to the Athletic Insurance office and not taken or sent to the coach or athletic trainers. This creates delays in filing a claim. With due respect to varying health care provider billing cycles, statements for athletic related medical expenses that are presented to the athletic insurance office 30 days or more after their issue date may not be suitable for payment consideration. Claims must be filed within 90 days of the injury date.