Get Insurance Information Form - Midway College

The Insurance Information Form for Midway College is a crucial document that ensures proper processing of claims. This guide will help users understand how to accurately complete this form online, avoiding common pitfalls that may lead to delays.

Follow the steps to complete your Insurance Information Form successfully.

1. Click 'Get Form' button to obtain the form and open it for editing. This action provides access to the necessary document where you can enter your information.
2. Begin by filling out the athlete's information section. Provide the full name and birth date of the athlete. Ensure all details are accurate to avoid delays in claims processing.
3. Indicate the primary insurance subscriber by circling the appropriate option: SELF, FATHER, MOTHER, or OTHER. Fill in the corresponding details, including name, social security number, home address, home phone number, employer details, and insurance company information.
4. In the primary insurance section, complete the ID/Policy number, group number, and annual deductible. Make sure to circle the correct deductible amount to reflect the athlete's plan.
5. Fill in the insurance claims address and member service/claims phone number for the primary insurance provider. This information is vital for any claims submissions.
6. Determine the type of insurance plan by selecting HMO, PPO, or OTHER and provide additional details if necessary. Also, specify if preauthorization is required for treatment and whether a second opinion is needed before surgery.
7. Repeat steps 3 to 6 for the secondary insurance subscriber if applicable. Ensure to circle the correct option and provide all necessary details just as you did for the primary insurance.
8. Read the authorization statement carefully. This section allows Midway College to access medical records and authorize payment for covered medical expenses. Sign and date the document where indicated.
9. Before exiting the form, review all entries to ensure completeness and accuracy. Look for any missing fields or inaccuracies that could affect your insurance claims.
10. After final review, you can save changes made to the form, and if needed, proceed to download, print, or share the completed document for submission.

Complete your Insurance Information Form online now to ensure prompt processing of your athletic-related claims.