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Athletic Training and Medical Services Insurance

2011-12 FORMS
Arrow 2011-12 Student-Athlete Insurance Form
Arrow OSU Athletic Insurance Claims Processing Procedures

OSU ATHLETIC INSURANCE CLAIMS PROCESSING PROCEDURES
If your son or daughter requires medical treatments while participating in intercollegiate athletics the following steps will be followed:

  1. Student-Athlete presents primary insurance information to provider at time of service.
      The Ohio State University requires all students carry useable insurance while attending classes at OSU.

  2. Provider files claim to student-athlete's primary insurance company.

  3. Student-Athlete/Parent receives statement for the services provided

  4. Student-Athlete/Parent forwards statement to the Athletic Insurance Claims office along with a copy of primary insurance explanation of benefits:

      OSU Athletic Insurance Claims
      242 WHAC
      535 Irving Schottenstein Drive
      Columbus, OH 43210
      Fax: (614) 292-5266
      e-mail: bonfini.2@osu.edu

  5. Upon receipt of the statement, the Athletic Insurance Claims Coordinator will contact the provider to verify the provider has filed the claim to the student-athlete's primary insurance. In addition, the provider is instructed to forward the appropriate HICF/UB92 form with the primary insurance EOB as soon as this process is completed with any outstanding balance to The Ohio State University Department of Athletics.

    The time in which the provider and your insurance company process the claim varies from 30 to 60 days or longer if primary insurance information is incorrect or incomplete. Student Athletes/Parents will continue to receive statements throughout this process.

  6. The Athletic Insurance Claims Coordinator upon receipt of the HICF/EOB and/or UB92/EOB will review the claim submitted by the provider and record the claim in the OSU Athletic Insurance Data Base.

  7. The Athletic Insurance Claims Coordinator will submit the HICF/EOB and/or UB92 for approval for payment to the Assistant Athletic Director of Sports Performance.

  8. Upon approval from the Assistant Athletic Director of Sports Performance, the AICC forwards HICF/EOB and/or UB/92 to OSUDA's THIRD PARTY ADMINISTRATOR, KLAIS AND COMPANY, for payment to the provider.

  9. KLAIS AND COMPANY reviews the claim, coordinates benefits, and sends a check on behalf of the OSUDA to the provider with the approved payment. A Klais and Company EOB is sent to the student-athlete. The time in which this process is completed routinely takes less than 30 days.

  10. The provider receives check from KLAIS and Company and must deposit the check in order for the account to be recorded as paid in full. Depending on the provider, the depositing and recording step takes at least 1 day to 15 days after receipt of the payment from Klais.

    A statement may cross payment time and deposit time. For example, statement date July 15, date of check mailing July 14, deposit of check July 17, and end of month provider records indicate statement paid in full.

  11. Monthly the OSU Athletic Insurance Coordinator receives a report from Klais and Company listing claims paid during that month on behalf of the Athletic Department.

IMPORTANT TIPS ...

  • SA must carry primary insurance card at all times.
  • SA must present current primary insurance information to provider at time of service.
  • The OSU Athletic Department is not your student-athlete's primary insurance coverage.
  • SA must turn in statement and explanation of benefits immediately to the OSU Athletic Insurance Claims Coordinator.

CLAIMS IN COLLECTION
90 days after a claim is generated a provider can place your account in collections. It is your responsibility to keep your primary insurance up to date in the OSU Athletic Insurance Office, to give each provider your primary insurance information when you receive services and to review each statement to verify that your claim has been filed to your primary insurance. Athletics cannot process a claim without the claim processed through your primary insurance first. Coordination of benefit issues are your responsibility as well as updating your student status. Any of these issues may hold up payment from your primary insurance company with the result of your claim being placed in collections.

Any questions or concerns, contact:
OSU Athletic Insurance Claims Coordinator
242 Woody Hayes Athletics Center
535 Irving Schottenstein Drive
Columbus, OH 43210
Phone: (614) 292-4367
Fax: (614) 292-5266

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