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Presented by: Linda Heady, MBA Insurance and Billing Coordinator.

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Presentation on theme: "Presented by: Linda Heady, MBA Insurance and Billing Coordinator."— Presentation transcript:

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2 Presented by: Linda Heady, MBA Insurance and Billing Coordinator

3  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.

4  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

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6  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

7  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.

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13 Our Providers

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15  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.

16  You will receive an insurance card:

17 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.

18  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

19 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

20 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

21 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

22 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

23 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

24  You will receive an EOB (Explanation of Benefits) from Klais

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