By Paige Quiggins
United States college health services billing practices have been questioned, but University of Louisville is striving to make the student’s needs come first.
According to Chad Henderson, president of the American College Health Association and director at University of Rhode Island’s health services, college health care can range from a single nurse facility to a full-scale ambulatory care clinic; each one having their own stipulations on insurance, accommodations and available treatment.
Henderson said private insurance plans usually have a preferred provider network list that may not include the student’s institution or out-of-area service provider, which could result in a financial burden at the time of service. Policies determine whether or not students can be seen certain providers at specific locations, which procedures are covered and whether or not the co-pay is due at the time of visit.
Dr. Phillip Bressoud, Executive Director of Campus Health Services, said some campuses are cash only operations, which creates a problem for students seeking reimbursements. Others have their own plans and/or health fees; do not bill private insurance because of added paperwork or hassle.
“It is an administrative burden placed upon the health center,” said Henderson.
According to Henderson, one billing mishap can occur because of simply being mailed to the wrong address, using the incorrect form or procedure. Aetna, like many other commercial carriers, has 16 billing locations for specific plans and different forms for each one. One discrepancy through Chickering/Aetna from 1998 to 2008 affected 67 U of L students. Bressoud said the company had been using databases to file claims that were not up to date, but it has been fixed since then and roughly $60,000 will be re-distributed to those students.
Bressoud said many campus health facilities provide a service, charge a fee and hand the student a bill and are out of the game from then. According to Bressoud, of the cash only operations, only 24 percent of private insurance holders surrendering the cash co-pay receive the reimbursement from the commercial carrier third party.
According to Henderson, third party claims adjudicators, commercial carriers, decide whether or not unlisted providers’ services are reimbursement-legitimate for to the policy holder. A visit to the out-of-provider-list emergency room for a sprained ankle may not qualify as an emergency according to the policy due to individual specifications for covered locations and services.
By taking the extra step of billing private insurance, Bressoud said CHS is able to generate revenue for their budget by taking the extra step to meet the needs of students.
“We always take care of the student first and worry about the bill later,” said Bressoud.
Approximately 7000 students are currently covered by the health fee and announcements are made at orientation for parents and students’ consideration for waiver.
Brooklyn Embree, a freshman nursing major, said she has not had any problems with her private insurance being accepted at CHS. She believes the waiver process was fast, easy and efficient. “I just got on ULink and clicked,” she said.
Junior Thomas Benford, a junior business finance major, said he has been unaware of the fee for three years, which could be the case for other students. He believes a plausible solution to try to ensure the entire student body awareness is to send out frequent groupwise e-mails to current students and notify transfer students also.
“When they first have to meet an adviser there should be something in the packet they get to say that it can be waived,” Benford said. This would allow for any newcomers who are not required to attend an orientation session to understand they have the right to waive the fee if they already have a health care service provider.
Henderson has advice for parents at college orientation when looking at their current and campus healthcare plans to determine which is best.
Examine the individual plan and see what it covers and check for a list of available providers. The location of the students for the next 12 month period and the length of plan and its coverage should be considered also because of differences in out of area cost and services.
Bressouds advice is to examine the school’s options along with the current policy; some parents prefer to pay the fee to cover small things such as weekly allergy shots because of high deductibles on private insurance plans. The health fee includes an unlimited number of basic visits with no co-pay, no drawing fees for blood work, allergy and flu shots, pap smears, tuberculosis tests and physical exams but is not an insurance policy. Bressoud said the grace period for seniors after graduation is usually up to three months at CHS.
