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Medical Billing Information

Like your primary care medical office, CHS bills each student’s medical insurance for reimbursement of health related services. We do not bill insurance companies for counseling visits at this time. We consider the mandatory college fee that students pay to be the annual copay, which means that no additional copay is required to use our services. In addition, we do not balance bill students or families for services not covered at 100 percent under their plans. This means that any charges not paid fully by insurance plans, such as deductibles, will not be billed to policy subscribers or students and will be written off.

What does health services provide me/my student?
Our medical health staff includes experienced nurse practitioners and a consulting physician, who can address many of the health care needs of students while at Salem State University. These include, but are not limited to, visits related to illness, injury, immunizations, reproductive health, health promotion, and wellness. We collaborate with our student’s primary care providers, when necessary, to provide local, on-site quality care and can provide prescriptions as well as referrals for off-site for specialty services as necessary.

We will continue to offer sliding scale options for students who choose to not use medical insurance for reproductive services, which includes access to on-site birth control options and infection screenings.

Who can use health services?
Any student enrolled in Salem State University course(s) is eligible to use the services of counseling and health services. Students with the university sponsored health plan as well as any other private or public plan are eligible to use our services. Contractual agreements with certain insurance plans may limit our ability to provide certain services, such as immunizations, on-site. In such rare cases, we will work with students to assist in community resources to address those concerns. Coverage of certain services may change based on plan specifics, but there is no out of pocket cost for any student to use our services and no one will be denied access to our services due to insurance issues.

Do I need to have the school health insurance to use counseling and health services?
No. Any student, regardless of what type of insurance they have, or if they do not have insurance, can use the student health services office. If you know that you have an HMO plan or other plan that may require a referral for billing, please contact your PCP ahead of time to help us arrange this process. If you have any questions, please contact our medical billing specialist, Cecile Gagne at CHS 978.542.7299, or send email to cgagne@salemstate.edu

What do students need to know before their visit?
Students should use our health services portal to schedule an appointment for health services. For counseling appointments or more urgent health appointments, call 978.542.6413. We make every effort to provide students with same day appointments as provider availability allows. Students should plan to arrive 10 minutes prior to their appointment time, in order to complete any necessary forms. If you have necessary forms available to you on the health services portal, you can complete them on your own computer before your appointment. Students should always bring their ClipperCard and insurance card, or medical insurance information, to each visit. We ask students to please call to cancel or reschedule if they cannot make a scheduled appointment time. You can cancel your appointment using the health services portal as well.

Counseling and health services, located in the Ellison Campus Center, room 107, North Campus, is open from 8 am–5 pm, Monday – Friday throughout the year, including summer break and winter session.

What is a copay?
A fixed amount (for example, $15) that you pay for a covered health care service, usually when you get the service. The amount can vary by the type of covered health care service in the insurance plan. Copays are not collected at Counseling and Health Services. We consider the mandatory college fee that students pay to be the annual copay.

What is co-insurance?
Your share of the costs of a covered health care service, calculated as a percent (for example, 20 percent) of the allowed amount for the service. You pay coinsurance plus any deductibles you owe. For example, if the health insurance or plans allowed amount for an office visit is $100 and you've met your deductible, your coinsurance payment of 20 percent would be $20. The health insurance or plan pays the rest of the allowed amount.

What is a deductible?
The amount you owe for health care services your health insurance or plan covers before your health insurance or plan begins to pay. For example, if your deductible is $1,000, your plan won't pay anything until you've met your $1,000 deductible for covered health care services subject to the deductible. The deductible may not apply to all services. Note that all copay and co-insurance costs will be covered by student fees and not billed to students.

How will I know what my insurance is being used for?
When your insurance company processes a claim for medical services, you will likely receive an explanation of benefits summary. This practice may differ based on your insurance carrier's policies.

What is an Explanation of Benefits (EOB) summary?
A statement sent by a health insurance company to a covered individual explaining what medical treatments and /or services were paid on their behalf. This may be provided in a mailed summary or by electronic communication based on your insurance carrier's practice.

How to Protect Your Confidential Health Information

In July 2018, the state of Massachusetts passed legislation to improve the ability for patients to protect access to their confidential health information. The law specifically addresses protections with insurance practices when a patient is covered under someone else's insurance, such as a parent or spouse. To learn more, visit Protecting Access to Confidential Healthcare.

What should I do if I get a bill for services rendered at CHS?
Do not pay any bills until you speak with our office. Call 978.542.7299 to discuss the bill with our billing specialist, Cecile Gagne. When you call please have the following information ready:
Your student ID number
Statement/ bill in question
Health insurance card or policy information number

 

Who can I call or talk to if I have additional questions or concerns?

Call Cecile Gagne at CHS 978.542.7299, or send email to cgagne@salemstate.edu. We make every attempt to get back to you within three business days.