presented by: linda heady, mba insurance and billing coordinator
DESCRIPTION
Presented by: Linda Heady, MBA Insurance and Billing Coordinator. Things you should know about the US Health Care System:. The system is privately funded, not government sponsored or socialized Payment is the responsibility of the individual, with or without health insurance - PowerPoint PPT PresentationTRANSCRIPT
Presented by: Linda Heady, MBAInsurance 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: 270-781-3910 Cost is $50
Greenwood Clinic: 8AM-6PM Mon-Fri, 8AM-2PM Sat Phone: 270-843-5662 Cost is $50
Call 911 Go to the Hospital:
Greenview Emergency Room (Hospital):
Phone 270-793-1000 Medical Center Emergency Room (Hospital):
Phone 270-745-1000
Cost is at least $250 or more depending on the number of services required.
Our Providers
Student Health Insurance – Major Medical Insurance Plan $739 per semester health insurance fee
pays for insurance coverage from August 1, 2013 until December 31, 2013.
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-NetworkProvider(First Health)
Physician Office
You pay $0AHP pays 100%
You pay $50 You pay $50 AHP pays 60% and you pay 40%
Physician Office
In-Network Provider(First Health)
Out-of-NetworkProvider(First Health)
Urgent Care You pay $50 AHP pays 100%
You pay $50 AHP pays 60% and you pay 40%
Emergency Room (Hospital)
You pay $250AHP pays 100%
You pay $250AHP pays 60% - you pay 40%
Urgent Care or Emergency Room
WKU Health Services IN NETWORKFirst Health(If a complex Lab, Health Services sends it to QUEST)
OUT-OF-NETWORKFirst Health
You pay $0AHP pays 100%Some of these include: UA, Glucose, CBC, Flu, Strep, Mono, Pregnancy Test, Wet Prep Stain, prep for fungal elements on skin
$50 copayAHP pays 100%Some of these include: Pap Smears, Lipid Panel, Liver Tests, Comp Metabolic Panel, Gonorrhea & Chlamydia testing
$50 copayAHP pays 60% - you pay 40%
Laboratory
IN NETWORKFirst Health
OUT-OF-NETWORKFirst Health
Hospital Expenses AHP 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%)
Surgery AHP 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 NETWORKFirst Health
Prescription Drugs Some medications available
You pay $15 for genericYou pay $30 for brand name
Immunizations and Prescription Drugs
You will receive an EOB (Explanation of Benefits) from Klais