Primary Insurance Verification

Each collegiate institution handles primary insurance differently. Some require primary insurance and some do not. Those that do not are faced with paying the full cost of surgeries and medical care for injured uninsured student-athletes. Those that do require proof of primary insurance are faced with a different challenge: how to ensure the primary insurance is valid throughout the year.

If you are like the majority of collegiate institutions today, you do not have a dedicated insurance coordinator who handles all primary and secondary insurance duties throughout the year. If you are lucky enough to have a person in that role, taking the time to call each individual athlete’s insurance can be very time consuming. Assuming that you were given a copy of their ID card, you can call the number on the back of the card to “verify benefits”. Some insurance carriers will only speak to you after verifying you are a medical provider and have the authorization to inquire about the validity of the insureds insurance policy. You will spend an average of 15 minutes per student athlete verifying the coverage via the telephone and chances are you will not be able to get through to speak to anyone or confirm coverage at all. This can amount to a substantial amount of time spent making sure these student-athletes have coverage and we know athletic trainers certainly don’t have the spare time.

The solution: Outsource this task to a company that provides an automated solution that will save you time and money. A student-athlete’s primary insurance may lapse unintentionally if a parent loses their job, divorce, late payments, missing information, employer errors or perhaps the coverage available is unaffordable.

Whatever the reason may be, having the knowledge and confirmation of primary insurance is critical to your insurance program. These days, a torn ACL can reach $30,000. Your secondary insurance program will be stuck with the bill if there is not primary insurance in place. By hiring a company to verify your athlete’s primary insurance, you can prevent those large claims from hitting your secondary which could save you thousands in future increased premiums. As a leader in the athletic insurance marketplace, Dissinger Reed has developed the premier solution, Coverage Backer™. For only 75 cents per verification, we return a list of the active and inactive insurance policies that your student athletes provided to you upon arrival to campus.

Although we never like to think it possible, there are athletes who will take advantage of the system. Showing valid coverage upfront during check-in and then canceling it after the first month has passed and they are successfully on the team, happens more frequently than we are aware. This can be avoided by using the Coverage Backer™ program on a monthly or bi-monthly frequency.

Scenario A:

Student athlete arrives to campus in the fall for student-athlete orientation and pre participation exams. He provides the athletic training staff with a copy of his primary insurance ID card. The athletic trainers file the copy away in hopes the student athlete will not be injured. Inevitably, this young man suffers an injury. An appointment with the doctor is set but upon check-in at the reception desk, it is determined his insurance is no longer valid. His mother lost her job and insurance coverage 6 months ago. They didn’t bother informing the college/university.

Now you have the potential of a $10,000 bill hitting the secondary insurance plan, depending on what the doctor determines necessary for rehabilitation. This entire amount will fall on the secondary insurance plan and likely lead to increased insurance premiums for the institution.

Scenario B:

Student athlete arrives to campus in the fall for student-athlete orientation and pre participation exams. He provides the athletic training staff with a copy of his primary insurance ID card. This time, the athletic trainers input the data from the card (insurance company name, member ID#, parents names, etc.) into an excel spreadsheet. Once all student athletes have arrived and the spreadsheet is complete, the athletic trainer sends it to Dissinger Reed to run through their Coverage Backer™ program. Within 48 hours, Dissinger Reed will return a complete list of the insurance policies and indicate if they are active, inactive, or needs review (missing information that is not allowing the system to read properly).

It is determined this athlete’s insurance is not valid and he is pulled from participation until he can provide valid primary insurance coverage. Increased claims total have been avoided for the cost of 75₵ per verification.