The new Student Health Center (SHC) located just off of West Linden Street has brought with it many new facilities and services for students to use. From ultrasound appointments, to blood tests, to regular immunization; the Health Center seems to be, as Michael King, senior administrative director of the SHC described it as, “a one-stop shop” for student’s health needs. The building itself, with its vast space, is able to “grow with the campus” and reflect the student body’s needs as time passes. Averaging about 420 appointments a week, the student health center has started its time at the University of California, Riverside (UCR) with a bang.
However, a student’s ability to access the services offered at the health center is largely determined by their healthcare plan. Indeed, anyone who has considered indulging in the services offered at the SHC must come to terms with the fact that the SHC does not accept third-party insurance. As of right now, the SHC will offer care without out-of-pocket fees to those on the University of California Student Health Insurance Plan (UCSHIP) or Highlander Care, another student healthcare plan that allows students to access a limited amount of services for a reduced price. While the SHC is open to all students regardless of their healthcare plan, those who have chosen to opt out of UCSHIP and Highlander Care may have to take a different route.
As Erica Castillo, supervisor of insurance, billing and front desk services, explains, those with third-party insurance will have to communicate directly with their provider to receive a reimbursement. Students must reach out to the health center to access the invoice for the date of service before submitting it to their insurance provider. They would then have to follow the needed process for their healthcare plan in order to fill out a claim reimbursement and “provide the invoice to their insurance carrier.” Prior to the reimbursement, these fees would be forwarded to a given patient’s student account where they would then be paid out of pocket. However, not all companies accept reimbursements at the SHC, deterring students from finding healthcare providers outside of UCR, causing students to have to pay out of pocket fees or accepting a slightly reduced price health insurance such as Highlander Care.
King elaborated further, saying that this process was not entirely uncommon from what many experience beyond college when someone is out of their provider network. UCSHIP functions through different vendors that contribute towards the health insurance plan. Unlike many outside insurance plans that students might experience after their time in college, the SHC has what is known as a charge master, ensuring “the prices would not be different for somebody with UCSHIP or Highlander Care, or they come in and pay and get reimbursed.” This ensures that the Health Center maintains set fees, charging each student the same amount regardless of their healthcare plan.
The services and programs that are provided to those with UCSHIP are due to contracts with companies such as Anthem Blue Cross, Delta Dental and Optum, which offer “very competitive” prices for students. These companies present their services to the university where they are then evaluated before being either approved or disapproved at the University of California Office of the President (UCOP) executive board, which consists of two representatives from each UC. At UCR, representatives are chosen from the Student Health Advisory Committee (SHAC).
Student health concerns are often brought up and negotiated by SHAC, and brought up to individuals such as King and Castillo who also received feedback from UCOP. This team of seven to eight individuals consisting of both undergraduate and graduate students represents UCR’s student body in regards to health decisions. Furthermore, two representatives are also sent to the executive committee at UCOP to meet and discuss the greater needs of students. Their input is extremely important in regards to deciding how prices are set, and what major health related issues are concerning UCR’s student body.
In short, while the SHC may not directly accept third party insurance, those without school insurance may not be completely cut off from receiving on-campus healthcare. Before students make a decision regarding UC insurance options, communication with healthcare providers to understand individual reimbursement situations is imperative to understanding what services are deemed accessible on a person to person basis. The SHC is meant to provide healthcare solely for students, and is built to accommodate their needs, so understanding one’s standing with the organization will make for an easier and more affordable college experience at UCR.
