EVALUATION, MEDICAL REFERRALS, RETURN TO PLAY

A. Evaluations:

1. Injury evaluations are an important part of athletics and the function of an athletic trainer. An injury/illness evaluation helps to determine the extent and nature of a health issue, necessary or recommended medical treatments and referrals, proper rehabilitation protocols, return to play, verification for medical insurance forms and payment, and documentation of the frequency of health issues. These items not only help the student-athlete, but also Southwestern College and the Athletic program as a whole.

2. When a student-athlete is injured (non-life threatening) at Southwestern College, the athletic training staff should be notified before any other action takes place. Obvious, emergency, and urgent injuries (i.e.; life-threatening injuries, major joint dislocations, fractures, open wounds requiring stitches, obvious concussion) are examples of exceptions to the rule. Otherwise, ANY medical, physician, or other hospital visits made without prior notification to the athletic training staff will not be covered by Southwestern College and the all financial responsibility will fall on the student-athlete in such cases.

3. If a student-athlete is injured during an away event and Southwestern Colleges' Athletic Training Staff are not present, the certified athletic trainer or other medical coverage personnel of the host school should be notified for an evaluation. After the evaluation, the Southwestern College Athletic Training Staff should be notified upon return to campus to follow up on the initial evaluation. Ultimately, it is the responsibility of the student-athlete, not the coach or the host athletic trainer to notify us of any injury. If the Athletic Training Staff is not properly notified, the student-athlete may be unable to receive the benefits from our secondary payment.

B. Medical Referrals:

1. Except for emergency transportation and treatment, all medical referrals must have prior consult and approval from the Athletic Training Staff at Southwestern College. Medical services rendered prior to this approval could become the sole responsibility of the student-athlete. You must see a doctor within 60 days of the initial injury for our secondary coverage to cover.

2. Student-athletes must attend all rehabilitation, treatment, AT follow-up, and doctor appointments, or cancel and reschedule 24 hours prior to the visit. Failure to keep any medical appointments could release Southwestern College of all financial and legal responsibilities. While the Athletic Training Staff will do its best to assist the student-athlete in finding transportation, we cannot provide transport, and will not pay for gas, food, or mileage.

3. Southwestern College and its team physicians (Orthopaedic and Sports Medicine at Cypress & AOA) will do our best to see your son or daughter ASAP for their athletic injury. You may choose to see the physician of your choice; however, regardless of whom you choose for your medical care all medical referrals and information must first be brought to the Athletic Training Staff at Southwestern College. If you choose to use a physician besides the team or other referred physician(s), the student-athlete must list the Athletic Training Staff as someone with HIPAA release privileges with their medical provider(s). In addition, you must provide the staff at Southwestern College with the doctor's name, address, and phone number for consultation and written documentation of the visit, including medical clearance, within 24 hours of the visit. This information is to be given to the Athletic Training Staff and not go through a coach or parent.

C. Return to Play:

INSURANCE PROCEDURES

Injuries do occur, and we attempt to provide our athletes with the very best possible care. Medical bills are incurred when the athlete is treated, whether it is locally, during a road trip or by a medical vendor in his/her own home area. The athletic accident insurance coverage provided by Southwestern College through Trustway T.E.A.M. for your son or daughter is for accidents (a sudden, specific definable event) sustained while participating in the play or official practice of intercollegiate sports at Southwestern College. College athletic coverage is a secondary provider, but will suffice as a primary if one is not available.

PROCEDURES TO FOLLOW WITH MEDICAL BILLS:

1. All bills must first be filed with your primary insurance company.

a. All medical bills for your son/daughter incurred as the result of an injury in the intercollegiate sports program will be sent directly to your son/daughter or to your home address (whichever they prefer). In some cases, the athletic department may get a copy of the bill(s), but in no case will the athletic department be the primary place for the bill(s) to be sent.

b. Submit the bills incurred to your primary insurance first and they will do one of two things:

i. Honor the claim and pay all or a portion of the bill(s)

ii. Not honor the claim and send you a letter of denial. An example might be that your son/daughter is no longer a part of your group policy after attaining the age of twenty-three.

2. Southwestern College will file a claim with our secondary provider (Trustway T.E.A.M.) on your behalf.

3. The secondary provider will review the balances not paid by your primary insurance company and cover those expenses. They need the following:

a. Explanation of Benefits (EOB), they are the notification you receive from your insurance company showing the amount they are paying on the claim and leaving what balances that still need to be paid.

**Bring the EOBs or any other bills you receive to us IMMEDIATELY so that we can begin the process of getting these bills paid. Otherwise you run the risk of being turned into collections for not paying--If we don't know about the bill, we can't get the bill PAID!

4. Any and all provisions of your policy are your responsibility. Office visit co-pays, primary care referral policy and network provider provisions are the most common provisions. Be sure that your son/daughter understands how to use the policy before they come to school and has a copy of both sides of the insurance card in their possession. You (they) will be reimbursed for these expenses, but you will be charged upfront. (KEEP YOUR RECIPTS)

5. Conditions existing prior to your participation at Southwestern College will not be covered. The student athlete must provide appropriate medical clearance to participate in athletic activities while at Southwestern College.

6. Student athletes, by choosing to participation in intercollegiate athletics, assume responsibility for their well-being. Athletes are expected to use good judgment, reasonable care, and common sense when dealing with an injury. Student athletes must communicate with coaches, parents, and the athletic trainer immediately following an injury and throughout the process.

7. Student Athletes must have a new physical each year and that physical can only be done by a Physician, Physician Assistant, or a Registered Nurse. Returning athletes with any injury in the previous 12 months must also have a signed medical release from their attending physician to participate in our program.