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Insurance
Questions & Answers
Below are some frequently asked questions
regarding the USASA player insurance that you
receive as a member of NCASA.
1.
Where can I get a
claim form?
2. How do I
file a claim?
3. What is
Primary Carrier?
4. What is
Excess or Supplementary Coverage?
5. What if I
do not have any other Health Insurance?
6. What is
considered an itemized bill?
7. What is an
Explanation of Benefits?
8. What is
payment calculated?
9. Do I have
to fill out a claim form every time I submit
bills?
1.
Where can I get a claim form?
There
is a claim form available online here,
along with instructions on how to file a claim.
2.
How do I file a claim?
There
is an explanation of how to file a claim here,
as well as a downloadable claim form.
3.
What is Primary Carrier?
The Primary Carrier is the insurance company who will
consider your medical expenses first and issue
any eligible payments.
A Primary Carrier is any Health Insurance
Plan through your place of employment, a family
plan through a relative’s place of employment,
a University health plan for college students,
Retirement policy, or other accident policies
and/or Medicare.
4.
What is Excess or Supplementary
Coverage?
This is a coverage that will reduce your out of pocket
expenses after your Primary Health Insurance has
paid your eligible medical expenses.
5.
What if I do no have any other Health Insurance?
Then, the USASA plan will be considered the Primary
Carrier. Keep
in mind that if this is the case, it will not
change policy limits, guidelines or procedures.
You will be responsible for any
difference between what the provider charged and
what the insurance companies paid.
6.
What is considered an itemized bill?
An itemized bill will have all the following: the
complete name, address, phone number and tax
identification number of the provider (doctor or
hospital). It will also have a diagnosis code,
live digit procedure codes, dates and services
rendered and the amounts charged.
7.
What is an Explanation of Benefits?
An Explanation of Benefits (commonly abbreviated EOB) is
a statement your Health Insurance company sends
to you whenever they process a claim.
It will show the types of services, how
much was allowed, how much was applied to a
deductible and the amounts charged.
8.
What is payment calculated?
We look at what the provider charged (before primary
carrier calculations) and determine the maximum
allowable based on our limits.
Then, we check to see if you have
satisfied your accident deductible. If the deductible has not been satisfied, we subtract
the deductible amount from the allowed charges. If there is a balance left, we then look to see what the
primary carrier paid.
This is deducted as well.
Any balance due, after the above
calculations, is remitted to the participant or
health care provide.
9.
Do I have to fill out a claim form every time I
submit bills?
No, additional forms are not needed once we have
received your validated claim form.
Additional medical bills and Explanation
of Benefits can be sent directly to the
insurance company for handling.
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