School's Responsibility

Parent's Responsibility

• Complete the claimant’s section (Part 2) of the claim form in full for all claims.
• Attach all itemized medical bills that have been incurred for all claims.
• Attach all explanations of benefits (EOB) or notices of denial from the primary insurance carrier for All Sports claims.
• Make sure the physicians and other providers of service send all subsequent itemized bills to the address on the claim form.

Other Important Information

• Providers DO NOT need to send an additional CLAIM FORM with subsequent bills as long as we have a claim form on file. The bills must be submitted to the address on the claim form along with the social security number and school district name.
• BILLS CANNOT BE PROCESSED UNTIL THE CLAIM FORM IS ACCURATE AND COMPLETE.
• Mail claims and Correspondence to:

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