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 UnitedHealthcare 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 (see non-participating insurance companies and special requirements), and the final amount due from you (if any) is billed to your student account after insurance payment has been received. It typically takes 30-60 days for claims processing and payment, and up to an additional month for charges to be applied to your student account. For the few insurance companies that are non-participating, 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 or Humana coverage who want charges submitted to these insurance companies need to designate us as their primary care provider. Front desk staff can assist you with this process.

Review Your Statement

You can review a statement of charges from your visit and your current balance at mystudenthealth.miami.edu under the Statements tab. 

 Picture of statements tab on student health portal

 

Past statements on health portal 

Example of past statement

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 us 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

* 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 vary)

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, and the balance remaining after payment by your insurance is charged to your student account. 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. Your final charges will never be above and are typically much lower than the self-pay charges. 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.

Self-pay charges

STD Testing


Gonorrhea/Chlamydia $40
RPR(syphilis test) $10


X-Ray & EKG

X-ray Chest PA/ lateral $75
X-ray Other $65
EKG $55


Vaccines

Tdap $55
MMR $100
HepA $85
HepB $95
HPV-9 (Gardasil 9) $235
Meningitis $140
Typhoid $105
Yellow Fever $165
Administration (first) $35
Administration (add’l) $35
PPD (Tb test) $30


Titers (Blood test to confirm immunity, in lieu of vaccination)

Mumps Titer $25
Measles Titer $25
Rubella Titer $25
Varicella Titer $25
Hep B surface antibody $20


Common Lab Tests

CBC (send out) $20
TSH (thyroid) $20
CMP (blood panel) $20
PT/INR $10
Lipids $25
UA (Urine test) send out $10
Urine Culture $15
Basic lab panel $15
Sickle cell $15
Liver Test $15
Free T4 (thyroid) $15
Free T3 (thyroid) $35
Culture (wound) $20
Throat Culture $15
Vitamin D25 $80
Stool Culture $25
EBV (mono panel) $85


Specialty Visits

Physical $65
Travel Visit $80
Women’s Health with pap $150
Women’s Health no pap $65