Billing Process for Insurance Claims
Student Health Service (SHS) will submit health insurance claims for clinical services. Once the claim(s) have been submitted and processed through the insurance company, all patient responsibility charges will be posted to the student's account including co-pays, deductibles, co-insurance or any non-covered services. Payment is not collected on the day of service.
If a student does not wish to submit their claim to insurance, a Do Not File Insurance Form is available that the student must sign for each visit they do not want processed by insurance. Students who sign this form are responsible for 100% of all charges rendered during their visit (which is charged to the student's account).
- Front and back of current insurance card (a photo of this information is acceptable)
- Policy holder's full name, address and date of birth
Students can submit their insurance information by uploading through to the Student Health Portal or email Teri.Shepherd@ndsu.edu. Without this information, we are unable to submit the claims to the insurance company. If the insurance information is not received within 3 business days from the date of service, all charges will be posted to the student's account. Any Customer Account Service (CAS) late fees incurred during this time will be the student's responsibility to pay.
Fees for Services
An itemized statement of all charges will post to the student's online Portal once charges have been sent to the student's account. This can be found by logging into the Student Health Portal and clicking on the Statements tab. Once the statement is available, the date of service will be listed as a PDF for review. Student's should receive an email notification once this statement becomes available.
Paying for Student Account Charges
Charges on the student's account can be paid via the following:
- Online through Campus Connection with credit card (fees may apply) or banking information
- Cash or Check payments accepted at NDSU One Stop, located on the main floor of the Memorial Union
- HSA (Health Savings Account) or FSA (Flexible Spending Account) payments accepted at NDSU Student Health Service by phone or in person
Balances that are more than 30 days past due are subject to a late payment fee from NDSU Customer Account Services. Past due balances may result in registration and/or transcript holds.
Will Student Health Service accept my insurance?
Student Health Service will submit claims to any insurance company, however, students are responsible to contact their insurance company prior to receiving care to verify coverage including, but not limited to, determining network status (in-network versus out of network), coverage for services, and referral requirements. It is important to verify this information with the insurance company as some policies state that if a student is further than 50 miles from home, or if utilizing a Student Health Center, that they will recognize that facility as in-network. If a referral is required, please provide this to Student Health Service so visits can be covered as in-network. All questions regarding a specific insurance policy should be directed to the insurance company.
Some insurance companies may ask for our specific NPI number. This information can be provided upon request by calling 701-231-7331.
Please see our Billing & Insurance Information Sheet for a printable version of our billing process, insurance information and frequently asked questions.
Need to enroll in a health insurance plan?
See our Insurance Resources for additional information.
What is Health Insurance?
Health insurance can be very complicated and confusing and some people do not know where to start or what questions to even ask. United Healthcare provides information called Health Insurance 101 to help those individuals better understand the basics of how it all works.
Common Insurance Term Definitions
- Coinsurance: The amount of money you owe to a medical provider once the deductible has been paid. Coinsurance is usually a predetermined percentage of the total bill. If the policy’s co-insurance is set at 15% and the bill comes to $100, the policy-holder owes $15 in co-insurance.
- Continuation of coverage: This is essentially an extension of insurance coverage offered to individuals no longer covered under a particular plan; it most often applies to former employees and retirees of companies that offer employee coverage. COBRA benefits (see Group Coverage section below) qualify as continuation coverage.
- Coordination of benefits: This process is applied by individuals who have two or more existing policies to ensure that their beneficiaries do not receive more than the combined maximum payout for the plans.
- Co-pay: This type of insurance plan is similar to co-insurance, but with one key exception: rather than waiting until the deductible has been paid out, you must make their copayment at the time of service. Most often, copayments are standardized by your plan, meaning you’ll pay the same $30 each time you see a physician, or the same $50 each time you see a specialist.
- Deductible: The amount of money you must pay out-of-pocket before coverage kicks in. Deductibles are usually set at rounded amounts (such as $500 or $1,000). Typically, the lower the premium, the higher the deductible.
- Dual coverage: The act of maintaining a health plan with more than one insurer. For example, many married people receive coverage from both their employers and their spouse’s employer. Others may opt to receive individual coverage from more than one insurer.
- Enrollment period / open enrollment: The window of time during which you can apply for health insurance or modify a plan to include your spouse and/or children. Policy-holders are unable to adjust their plan until the next open enrollment unless they experience a qualifying life event. These include a marriage, divorce, birth of a child, changes to individual/household income, or interstate residence relocation.
- Network Coverage:
- In-network: This term refers to physicians and medical establishments that deliver patient services covered under the insurance plan. In-network providers are generally the cheapest option for policyholders. Insurance companies typically have negotiated lower rates with in-network providers.
- Out-of-network: This term refers to physicians and medical establishments not covered under your insurance plan. Services from out-of-network providers are usually more expensive than those rendered by in-network providers. This is because out-of-network providers have not negotiated lower rates with your insurer.
- Out-of-pocket maximum: The amount of money you pay for deductibles and coinsurance charges within a given year before the insurance company starts paying for all covered expenses.
- Pre-existing condition: Any chronic disease, disability, or other condition you have at the time of application. In some cases, symptoms or ongoing treatments related to pre-existing conditions cause premiums to be higher than usual.
- Premium: The amount you pay your insurance company for health coverage each month or year.
- Referral: An official notice from a qualified physician to an insurer that recommends specialist treatment for a current policy-holder.
- Waiting period: Many employer-sponsored insurance plans mandate a period of 90 days before employees can enroll in their insurance plans.
**Definitions provided by MedicalBillingAndCoding.org