| Q |
Why would a college or university want to work with HCHG? |
| 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 HCHG to stabilize or improve the financial status of their health centers by billing insurance companies for clinical services provided to students.
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| Q |
Our health center is currently experiencing some financial constraints; how can we pay for Highland’s solution? |
| A |
HCHG understands the challenging financial conditions faced by most health centers – that is the very reason you should consider partnering with HCHG in the first place. HCHG 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.
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| Q |
Why would a college or university choose not to work with HCHG? |
| 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 HCHG's medical billing services - but even health centers with such capabilities might consider working with HCHG because our full turnkey service produces easy, efficient, and effective third party billing.
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| 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.
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| 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.
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| 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. 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?
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| 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; HCHG knows how to do that and can help.
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| 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. HCHG 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.
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| 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.
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| 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.
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| 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 HCHG 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.
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| Q |
Why shouldn't we just set up our own billing system? Why do we need HCHG? |
| 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 HCHG solves all of these problems without diverting the health center's attention away from essential student services. Why not let HCHG take care of the billing, so the health center staff can focus on taking care of the students?
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| Q |
But there are local companies and health care organizations that offer insurance billing services; why shouldn't we contract with them, instead of HCHG? |
| A |
HCHG 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. HCHG 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.
HCHG 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?
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| Q |
Does HCHG understand HIPAA regulations? How will HCHG protect
students' privacy? |
| A |
All of HCHG's policies, procedures and information technology are
fully compliant with HIPAA regulations. HCHG 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. HCHG’s Vice President of Compliance, Harold Whittington, is one of the nation’s most experienced leaders in health care regulatory compliance.
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| Q |
Must our Health Center meet any special technology requirements to perform third party billing? |
| A |
HCHG will work with you to set up a system of submitting claims that works for you. If your health center has an electronic patient information system, HCHG 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.
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| Q |
Will Highland’s solution require us to hire additional staff members? |
| A |
No. HCHG’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 HCHG’s billing professionals to collect new incremental revenue for you.
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| Q |
Does HCHG outsource college health programs? |
| A |
No. HCHG provides specific services and assistance to college health centers. HCHG does not outsource or manage college health centers.
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| Q |
What qualifications does HCHG’s medical billing team have? |
| A |
Click here to view our team's bios.
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