Parent Insurance Letter
Athletic Training
Graceland University
1 University Place
Lamoni, IA 50140
Dear Parent and Student Athlete,
With this letter you should have received a parent information form, and an athletic release form. Please return those to me with a copy of the student’s insurance card.
Graceland University provides secondary insurance to athletes that are injured during practice or games. Your insurance will be the primary payer, any remaining expenses may be covered by Graceland’s secondary athletic medical insurance. Athletes are required to have insurance to participate. Graceland University offers a student plan and you can contact student services if you are interested.
The following criteria must be met before the Graceland University athletic medical insurance policy can be considered:
1. The athlete and/or parent must authorize the doctor’s visit with Graceland’s Athletic Trainer(s). (Those who fail to meet Criteria 1 will be responsible for the medical expenses incurred during that visit.)
2. You must follow the procedures of acquiring medical care as stipulated by your insurance company.
3. You must submit any bills within one year of the injury for possible coverage under Graceland’s secondary athletic medical insurance policy.
4. You must see a physician within 30 days of the injury date.
Once your insurance has made payment you will need to send the following items to the athletic training room at Graceland University for possible payment by Graceland’s athletic medical insurance:
1. Itemized bill from the visit(s)
2. The explanation of benefits (EOB) notice from your primary carrier
3. A completed and signed insurance claim form (green & white form enclosed)
The athlete and/or parent must have met all 4 criteria for payment and forwarded the three above items to Graceland Athletic Training, at the address listed above, before we can submit the bill to our insurance company for review. If the above criteria and items are not met or received by the billing agency promptly (usually 90-120 days) the athlete and/or parent may risk being sent to collections. To avoid any complications and to facilitate payment, please follow the instructions in this letter. If you have any questions or concerns please give us a call at the number(s) listed below. Please keep this letter for your records.
Please contact Dana Hoffman if you have any questions.
Thank you,
Dana Hoffman ATC, LAT
641-784-5392
