Frequently Asked Questions

Below please note some of the questions Highland receives from potential campus partners.

Q Why would a college or university want to work with Highland? A If your campus health center seeks incremental dollars in your budget, without increasing either (i) the student health fee or (ii) fees for service, you should consider partnering with Highland. Colleges and universities choose to work with Highland to stabilize or improve the financial status of their health centers by billing insurance companies for clinical services provided to students.
Q Our health center is currently experiencing some financial constraints; how can we pay for Highland’s solution? A Highland understands the challenging financial conditions faced by most health centers – that is the very reason you should consider partnering with Highland in the first place. Highland will help you receive new, incremental revenue by billing insurance carriers for services you are already providing today. And Highland receives remuneration through a percentage of collections — not billings. There are also no dollars out of a campus health center’s budget, including customer service visits, software upgrades, etc.
Q Why would a college or university choose not to work with Highland? A College health centers that already bill health insurance companies for all clinical services provided to students (including office visits) and consistently recover high levels of revenue without incurring disproportional administrative costs might not benefit from Highland’s medical billing services – but even health centers with such capabilities might consider working with Highland because our full turnkey service produces easy, efficient, and effective third party billing.
Q Why would health centers that have not traditionally billed students’ health insurance plans for professional services want to start doing so? A Financial pressures on student services have increased; the usual funding mechanisms of student fees or allocations of general institutional funds are no longer "elastic" – there is little remaining room for increases. At the same time, demands on health centers have also increased because of regulatory requirements, new technologies, and higher expectations of students and their parents. Billing health insurance companies for professional services offers a new revenue stream that can protect health centers against future instability, permit them to develop new programs, and provide reserves for capital expenditures and emergencies.
Q Wouldn’t it be strange for a health center to bill students’ health insurance plans? A Billing health insurance for professional clinical services is only unusual in college health. Students (and their parents) are very accustomed to having their health insurance plans billed for services before college, and the same thing will happen after college. The standard procedures of health care are only interrupted during the college years. Presenting an insurance card when services are received is just part of the routine; there is nothing strange about it.
Q But won’t students be upset if we bill their health insurance plans? A Entering students will expect nothing else; it is exactly what they have been used to before coming to college. Returning students usually regard the beginning of insurance billing as evidence that the health center is becoming more mainstream – the absence of insurance billing in the past probably seemed unusual to them. Some students are currently paying out of pocket expenses for ancillary services that their insurance covers. Why charge students out of pocket dollars when their or their parent’s insurance will cover the expenses?
Q But what about confidential lab tests, including pregancy and STDs? A The EOB (explanation of benefits) from the insurance carrier should simply state "laboratory test." However, if a student does not want to risk something unusual appearing on his or her EOB, an alternative includes permitting the student to pay for the test in the same manner he or she pays today.
Q We already have a student health fee. If we bill health insurance companies, aren’t we "double dipping"? A No, but it is very important to clarify what programs and services are paid for by the student health fee, and what services are paid for by health insurance. Only reimbursable professional services, such as office visits with clinicians, and certain ancillary services (such as prescription drugs and some laboratory tests) are paid for by health insurance. Everything else – keeping the health center open, its administrative and operational functions, its non-clinician staff (including nurses, medical assistants, medical records staff, etc.), health education and health promotion programs, outreach services, liaison programs with residence halls and academic departments, public health functions, information systems – is paid for by the health fee. When a health center that has not previously billed insurance plans for office visits starts doing so, it is important to communicate the change effectively with students; Highland knows how to do that and can help.
Q But even if we clarify what the student health fee covers, won’t students and parents still feel like they are paying twice? A No. In fact, just the opposite. Today, students that have private insurance visit a campus health center and are generally charged out of pocket expenses for ancillary services such as a chest x-ray, when their insurance would typically cover the chest x-ray. While a student can certainly attempt to have the insurance company reimburse him or her for the chest x-ray, reality dictates that the insurance company has too much experience to allow the student a real opportunity to recoup his or her funds. Students and parents often inquire, generally during orientation, why campus health centers are not accepting insurance. Highland not only helps campus health centers derive additional income from professional services, but we save students and parents out of pocket expenses for ancillary services such as a chest x-ray.
Q What if the insurance company doesn’t pay for that x-ray? Won’t the health center lose money from that chest x-ray? A If the insurance company does not reimburse the campus health center for that x-ray, the campus health center will still have the opportunity to recoup the money from the student, which is the same procedure that would occur if that student were to visit his or her physician during the summer break; or what happens at the health center before working with Highland. However, why not first try to receive reimbursement from the insurance company rather than the student? After all, the student’s parents are paying premiums to the insurance companies.
Q Will Highland attempt to collect any uncollected insurance company revenue from the student? A Highland does not do that for any campus, either because the campus does not "balance bill" for any uncollected amount, or because a campus can simply perform that function itself. This policy illustrates one of the biggest differences between Highland and a typical billing company, the latter accustomed to taking a percentage of all revenue, not just insurance proceeds. If a campus permits Highland to balance bill, Highland can materially lower its percentage of collections.
Q Won’t insurance companies oppose this? A Perhaps counter-intuitively, the answer is no. Insurance companies would much prefer to pay a relatively small charge for the student who visits the health center, rather than a materially higher charge for the student who chooses to visit the emergency room. And students are sometimes more apt to visit a hospital, because hospitals accept insurance, and campus health centers typically do not. Insurance companies prefer the more efficient cost structure of a campus health center versus a hospital.
Q Some students are uninsured, or under-insured. Will the health center turn them away? A No, of course not. Health centers that work with Highland will continue to provide appropriate care and services to all students, regardless of their ability to pay or their health insurance status. Highland has processes to address uninsured students. In fact, current Highland partners have found insurance billing as an opportunity to educate uninsured students about insurance.
Q Why shouldn't we just set up our own billing system? Why do we need Highland? A It is definitely possible – but not very likely – that a health center could establish its own full-scale insurance billing operation. Given limited resources (space, personnel, funding), though, most health centers could not reasonably invest in the staff, information systems, financial accounting services, and customer service programs required. Few health centers have the administrative depth to manage credentialing, claims adjudication, and negotiation with insurance carriers. Finally, most health centers do not have enough experience to do insurance billing effectively – and their collection rates would suffer. Working with Highland solves all of these problems without diverting the health center's attention away from essential student services. Why not let Highland take care of the billing, so the health center staff can focus on taking care of the students?
Q But there are local companies and health care organizations that offer insurance billing services; why shouldn’t we contract with them, instead of Highland? A Highland is not just a commodity billing company. Our full turnkey service ensures your success, controls your risk, and makes the implementation of medical billing easy and efficient. Highland is not subject to the influences and pressures that make college health an unsatisfactory market for local billing companies; we work with college health, and only with college health.

Highland understands – far better than a local billing company would – how insurance billing in college health works, where the potential pitfalls are, and how to explain it well with students and parents. Wouldn't you prefer to have your billing operations managed by people who appreciate the unique features of college health programs and are sensitive to students’ special needs?
Q Why would we need Highland's managed care services? We are already accredited by AAAHC or JCAHO? A Accreditation presumably added tremendous credibility to your health center in the eyes of students. Unfortunately, the process for "credentialing" your providers with managed care organizations such as Blue Cross Blue Shield, UnitedHealth, Aetna, Humana, Cigna and others is completely separate from the "accreditation" process with AAAHC or JCAHO. In addition, managed care includes not only credentialing, but also contracting. Highland's experience in both credentialing and contracting on behalf of campus health centers results in a successful managed care experience. And once your providers become "in-network" with the large insurance carriers, it adds even more credibility to your program in the eyes of students.
Q We’re not accredited by AAAHC or JCAHO. Can we still get credentialed? A Absolutely. In fact, should you wish to pursue AAAHC or JCAHO accreditation, having credentialed providers should provide you with a substantial advantage.
Q Does Highland understand HIPAA regulations? How will Highland protect students’ privacy? A All of Highland’s policies, procedures and information technology are fully compliant with HIPAA regulations. Highland will work with health center staff to ensure that all personal health information is handled properly and that every element of the work we do together is consistent with HIPAA requirements. Highland’s Vice President of Compliance, Harold Whittington, is one of the nation’s most experienced leaders in health care regulatory compliance.
Q Must our Health Center meet any special technology requirements to perform third party billing? A Highland will work with you to set up a system of submitting claims that works for you. If your health center has a practice information system, Highland will work with your software vendor to create a seamless interface to our billing software. Although we prefer to submit claims electronically, our billing staff can handle paper claims efficiently and expeditiously.
Q Will Highland’s solution require us to hire additional staff members? A No. Highland’s third party billing solution requires some changes operationally within the health center, but no added staff members. Highland’s seamless, turnkey solution enables the health center staff to focus on providing health care to your students, while enabling Highland’s billing professionals to collect new incremental revenue for you.
Q We already provide a statement to students to submit to their insurance company for reimbursement. Why would I work with Highland? A The intent of providing the students with claim information to send to his or her insurance company for reimbursement is excellent. Unfortunately, students rarely receive reimbursement. First, the provider doing the service is likely "out-of-network" with the student's insurance plan. The student must then meet a higher "out-of-network" deductible. If this higher deductible is not met, the student receives no reimbursement. Second, the claim form given to students may not be coded in a format recognized by an insurance company. Further, many payors require electronic claim submission and typically deny paper claims on first submission. Finally, expecting a student to (i) research the location of the appropriate claim processing center, (ii) mail the claim, (iii) follow up with insurance company and (iv) fix any corrections in order to receive payment (assuming it's "in-network" or deductibles have been met) is unrealistic. Highland's entire business is focused in the college health market; why not let Highland process this transaction for you and your students?
Q My providers are out of practice in CPT coding. How much training is involved to satisfy payor documentation and coding requirements? A Our Coding and Compliance team, led by Mr. Harold Whittington, has decades of experience training providers on the latest codes and up-to-date coding techniques. His coding program typically consists of a few half day onsite trainings and a series of individual provider meetings. When it's time to commence third party billing and submit claims, rest assured that your providers will be trained as well, if not better, than most providers in the private community. We ask you to call our clients for a testimonial on the effectiveness of Highland's Coding Program.
Q If I wanted to get started today, how long would it take in order for my health center to get up and running with Highland? A Highland's implementation process can take anywhere from 6 to 9 months depending on myriad factors. While preparation, training & education, technology interfacing and student marketing can be done in less time, the managed care function can take much longer. Before ever submitting a claim, Highland urges their clients to become "in-network" providers with a majority of insurance plans that make up the student population. In order to do this on a college campus, this managed care effort takes an extremely talented team with contacts and experience in college health and in the insurance industry. Rest assured Highland has the experience to solve the managed care issues in college health — just ask our clients.
Q Does Highland outsource college health programs? A No. Highland provides specific services and assistance to college health centers. Highland does not outsource or manage college health centers.
Q What qualifications does Highland’s medical billing team have? A Click here to view our team’s bios.