Tulsa Hurricane
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Procedures For Securing Medical Assistance And Payment Of Expenses For Covered Injuries/Illnesses

Returning Student-Athletes
PPE Questionnaire

General Forms
Description of Medical Services
Insurance Form

1. All student-athletes must have a MEDICAL INSURANCE INFORMATION AUTHORIZATION FORM and the DESCRIPTION OF MEDICAL SERVICES FORM on file with the athletic training room prior to any participation. Please provide a copy of the insurance card, prescription card, and dental card. All insurance information must be updated annually at the calendar year, or any time the student-athletes' insurance information changes. If the updated insurance is not received the student-athlete may not be allowed to participate, and also runs the risk of not having his/her medical bills paid.

2. The University of Tulsa provides an excess medical insurance policy for your student-athlete's protection. This policy is not primary coverage, so it requires the student-athlete to use an individual or group policy whenever possible. After the primary insurance policy has paid its maximum, the policy that we provide will pay the remainder of the bill. We ask your assistance and cooperation by sending any bills from providers or explanation of benefits from your plan or your student-athletes plan. If your student-athlete does not have an individual or group plan, and is not covered under your plan, our policy will provide coverage of athletically related injuries and illnesses. This policy does not cover illnesses such as, but not limited to, pneumonia, spinal meningitis, appendicitis, and scarlet fever.

3. If the student-athlete is covered by a HMO, a provider will contact the HMO by phone to receive instructions as to what coverage is afforded if care is provided other than by the HMO physician.

4. The University of Tulsa Sports Medicine Department may seek reimbursement for rehabilitation services from the student-athlete's primary insurance company.

5. The University of Tulsa Sports Medicine Department strongly recommends that the student-athlete has their own medical insurance to cover medical expenses incurred due to unrelated or out-of-season injuries or illnesses. If your student-athlete is not already covered by an individual or group plan, the Alexander Health Center on campus offers a medical insurance plan for enrolled students. For more information about this plan please call 918-631-2241.

6. Only medications necessary for participation in intercollegiate athletics will only be paid for during the academic year (August-May) provided the prescription is written by a TU appointed physician. The student-athlete will present the prescription to TU Sports Medicine staff for approval and instructions on filling at an authorized pharmacy. If the student-athlete submits the prescription to an unauthorized pharmacy, The TU Athletic Department will not pay for any incurred expenses.

7. The student-athlete must take a referral form from the sports medicine department to all appointments including but not limited to the TU team physician(s), TU appointed specialist, diagnostic testing facilities, and The Alexander Health Center. If a referral form is NOT taken, the student-athlete and parent(s)/guardian(s) are responsible for bill(s) incurred.

8. The TU Athletic Department shall NOT assume any responsibility for incurred medical expenses due to illness or injury that occur outside of supervised athletic department sanctioned activities, and has the right to discontinue financial aid if the athlete is unable to continue intercollegiate participation due to medical reasons sustained from such situations. The athletic department will not pay for dental exams or necessary work unless such treatment is the result of an injury sustained during practice or competition.

9. Pre-existing medical conditions are the sole responsibility of the athlete.

**Revised May 2009