I am writing to you because your child recently was seen by a medical professional outside of our sports medicine clinic on the Shenandoah University campus. As we try to provide the best care possible for our student-athletes, there are times we need to seek outside resources. If you are receiving this letter, we thought it necessary to refer them to a local physician.
We make every effort to try to follow your insurance plan as best we can in the Winchester/Frederick County area. As a student-athlete at Shenandoah University, your child has an excess insurance policy provided for them by EIIA. To have services paid for, it takes a concerted effort of the student-athlete, his or her family and the Sports Medicine office.
Due to your child’s visit to the outside provider, the sports medicine staff has completed an electronically submitted claim form and placed a copy into their file. Initially, your insurance is billed; the NAGHA will pay what they deem customary and reasonable following the submission to your primary insurance provided.
When your insurance has been exhausted, please fax the additional expenses directly to NAGHA or have your child bring them to SU for an Athletic Trainer to fax. It is imperative that this is done in a timely manner for NAGHA to make a determination what they will be paying.
NAGHA asks us to remind you that payment is not guaranteed until the claim is approved by the NAGHA Claims Service. Even in that case, not all charges may be eligible for benefits.
There are times when NAGHA may deny a claim. We, at the university, do not have any authority in this matter. After the claim form leaves the sports medicine office, Shenandoah University or the athletic department does not have access to the claim or any funds for the incident involving your child. Shenandoah University does not take responsibility for payment to either the physician or the family. The best avenue for questions or concerns is through NAGHA.
For claims processing and service issues, please call our NAGHA advocates.
NAHGA Claim Services
PO Box 189 - 88 Main Street
Bridgton, Maine 04009
Tell them you would like the Shenandoah University Representative:
Ariel McConkey, Claims Adjuster
Main Contact 800-952-4320 x 1222
Michael Kotelnicki MS,ATC
Head Athletic Trainer