Presentation on theme: "Presented by: Linda Heady, MBA Insurance and Billing Coordinator."— Presentation transcript:
Presented by: Linda Heady, MBA Insurance and Billing Coordinator
The system is privately funded, not government sponsored or socialized Payment is the responsibility of the individual, with or without health insurance Even with health insurance, medical treatment in the US can be very expensive. Without health insurance medical treatment can be extremely expensive Before you visit a doctor, hospital or facility, always check to see if your insurance will be accepted.
Keep copies of all bills and papers for at least one year. You can ask a second doctor for an opinion before getting treated Inform your doctor about the conditions and medications you have had in the past You can ask the doctor questions about your conditions and medications you have had in the past
If after 4:30pm or on Saturday or Sunday and you can not wait until Monday to see a doctor: Go to: Urgent Care : 8AM – 8PM everyday Phone: Cost is $50 Greenwood Clinic : 8AM-6PM Mon-Fri, 8AM-2PM Sat Phone: Cost is $50
Call 911 Go to the Hospital: Greenview Emergency Room (Hospital): Phone Medical Center Emergency Room (Hospital): Phone Cost is at least $250 or more depending on the number of services required.
Student Health Insurance – Major Medical Insurance Plan $739 per semester health insurance fee pays for insurance coverage from August 1, 2013 until December 31, You will be charged $739 again in January for Spring 2014 Semester.
You will receive an insurance card:
Deductible – Dollar ($) amount you will need to pay before the insurance will pay. Co-Payment (Copay) – Specific dollar ($) amount you must pay at the time of service. Co-Insurance - Dollar ($) amount based on a percentage you must pay for services.
Preventative Care Annual Examinations Tobacco use screening and cessation Depression screening for adults Well women Exams Contraceptives/Birth control Nexplanon Contraceptive Placement Immunizations/Vaccines Hepatitis, HPV, Flu, MMR, Meningitis, Pneumonia, Tdap, Varicella
WKU Health Services In-Network Provider (First Health) Out-of-Network Provider (First Health) Physician Office You pay $0 AHP pays 100% You pay $50 AHP pays 60% and you pay 40% Physician Office
In-Network Provider (First Health) Out-of-Network Provider (First Health) Urgent CareYou pay $50 AHP pays 100% You pay $50 AHP pays 60% and you pay 40% Emergency Room (Hospital) You pay $250 AHP pays 100% You pay $250 AHP pays 60% - you pay 40% Urgent Care or Emergency Room
WKU Health ServicesIN NETWORK First Health (If a complex Lab, Health Services sends it to QUEST) OUT-OF-NETWORK First Health You pay $0 AHP pays 100% Some of these include: UA, Glucose, CBC, Flu, Strep, Mono, Pregnancy Test, Wet Prep Stain, prep for fungal elements on skin $50 copay AHP pays 100% Some of these include: Pap Smears, Lipid Panel, Liver Tests, Comp Metabolic Panel, Gonorrhea & Chlamydia testing $50 copay AHP pays 60% - you pay 40% Laboratory
IN NETWORK First Health OUT-OF-NETWORK First Health Hospital ExpensesAHP pays 80% of Preferred Allowance (You must first pay $300 deductible, then 20%) 60% of Usual and Customary Charges (You must first pay $600 deductible, then 20%) SurgeryAHP pays 80% of Preferred Allowance (You must first pay $300 deductible, then 20%) 60% of Usual and Customary Charges (You must first pay $600 deductible, then 20%) Hospital and Surgery Coverage
WKU Health Services IN NETWORK First Health Prescription DrugsSome medications available You pay $15 for generic You pay $30 for brand name Immunizations and Prescription Drugs
You will receive an EOB (Explanation of Benefits) from Klais