Charges for Services / Insurance Billing

Routine visits and common lab tests are provided at NO CHARGE to students who have paid the Health and Counseling Centers fee or the Medical Student Coral Gables Student Health fee.

In many situations, and always for students with the university-sponsored Aetna Student Health plan, the amount collected from your insurance provider will be considered full payment.

For students without the university-sponsored insurance plan, any additional charges are submitted to participating insurance companies soon after your visit. The final amount due is billed to your student account after insurance payment has been received.

For those students wh waived with a Nonparticipating insurance company, charges can be paid at the time of visit or billed directly to your student account. If for any reason you do NOT want us to bill your insurance provider, charges can be paid at the time of service.

For the few services not covered by insurance companies (e.g. travel visits) charges can be paid at the time of service or billed to your student account.

Students with AvMed, Cigna, Humana, or other insurance plans may need to designate Student Heath as their primary care provider. Front Desk staff will assist you.

Review Your Statement

You can review a statement of charges from your visit and your current balance at MyUHealthChart.com under the Billing tab. 

After your claim has been processed, your insurance company will send an E.O.B. (explanation of benefits) which explains the charges, negotiated discounts, amounts applied to the deductible, co-insurance, and copayment and the amount due from you, which is the final amount that will be charged to your student account. Charges to student accounts typically occur within 60-90 days of your visit. See below for an explanation of key terms that can help you understand your explanation of benefits. 

 A guide to key terms

Amount billed: The amount your doctor or health care provider billed for services
Member rate: The agreed-upon amount the in-network doctor or health care provider accepts as their fee
Amount you saved:  The difference between the amount billed and the in-network arranged pricing 
Pending or not payable:  A claim that needs more review by Student Health or an amount we did not pay
Deductible:  The amount you pay before your health plan will pay benefits
Coinsurance:  After you meet your deductible, the medical plan pays a percentage of the covered cost of some services and you pay the rest. Your share is called coinsurance
Copay:  A fixed dollar amount you pay when you visit a doctor or other health care provider
Other health plan:  This is known as coordination of benefits (COB). When a member has more than one health plan, both plans payments will not be more than the billed amount

 

No Cost Services

Many routine services, including most provider visits, are provided at no cost to you. The charge for these services will be billed to your insurance, however, any unpaid amount will be covered by the HCC fee.

Routine visits * No cost
Rapid Strep test No cost
Rapid Flu test No cost
CBC (Blood count) No cost
Monospot (Mono test) No cost
Finger stick glucose No cost
HIV testing No cost
UA (Urine test) No cost
Vaginitis test No cost
Cryotherapy (Treatment of warts) No cost
PPD read (Skin test for tuberculosis) No cost
Flu Vaccine No cost
COVID-19 Testing No cost

* Visits with charges include physical exam for a third party, travel, women’s health, and orthopedics visits.

Preventive Services (covered 100% in-network)

Preventive services are covered 100% (no cost to you) if your insurance is in-network,  as required by the Affordable Care Act or Obama Care.  To determine if your insurance is in-network for the University of Miami Student Health Service, contact the 800 number on your insurance card.

Screening and Counseling

HIV screening  for everyone ages 15 to 65, and other ages at increased risk
Hepatitis B screening  for those at high risk
Hepatitis C screening  for adults at increased risk, and one time for everyone born 1945 – 1965
Syphilis screening  for all adults at higher risk
Alcohol Misuse screening and counseling for all adults
Obesity screening and counseling  for all adults
Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
Tobacco Use screening  for all adults and cessation interventions for tobacco users

Immunizations  (for adults, recommended ages, and recommended populations)

Hepatitis A  (Hep A)
Hepatitis B   (Hep B)
Herpes Zoster  (Shingles)
Human Papillomavirus  (HPV)
Influenza (Flu Shot)
Measles, Mumps, Rubella  (MMR)
Meningococcal  (Meningitis)
Pneumococcal  (Pneumonia)
Tetanus, Diphtheria, Pertussis  (Tdap)
Varicella  (Chicken Pox)

Charges for All Other Services

Charges for services other than no-charge or in-network preventive care are billed to your insurance. Your final cost for these services depends on charges negotiated between the University of Miami Medical Group and your insurance company, your insurance plan's co-payments, co-insurance, and deductible, and whether or not your deductible has been met for the current calendar year. The balance remaining after payment by your insurance for all services after January 1, 2023, is located in your MyUhealthChart account from the Menu drop down under “Billing Summary”.

Self-pay charges apply if you prefer NOT to use your insurance coverage, or if your insurance is out of network and does not include out-of-network benefits. The Front Desk staff at Student Health can provide you with the self-pay cost for your visit for services that are not covered under the Health and Counseling Centers Fee.