November 2020 – Academic HealthPlans
 

Claims are Key – a Guide to Claims Audits and Readiness Assessments

Costs and Coverage, Risk Management

Properly adjudicated claims are a key goal of claims administrators, colleges and universities, and student members alike.

Inaccurately processed claims can end up being timely and costly. Overpaid claims will negatively affect claims experience leading to higher premium renewals. These can be especially harmful for self-funded plans where the college or university holds the risk. Underpaid claims can lead to additional time processing claims and handling appeals and some unhappy members.

The good news is that claims administrators take this very seriously and have comprehensive processes in place to ensure timely and accurate claims processing. That said, there may still be some that initially slip through the cracks.

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I’m Young and Healthy – Why Do I Need Health Insurance?

Student Health

It may be frustrating to learn that your college or university is requiring you to have health insurance. You are young and healthy and are already saddled with piling student debt.

Here is some food for thought: young + healthy ≠ invincible.

Let’s look at it like this:

If you drive a car, you are required to have auto insurance.  If you have a house, you need home insurance. We don’t expect accidents to happen, but when they do, we are prepared so we do not have to worry about forking over thousands of dollars to cover the property damage out of pocket.

Similarly, we should also prepare for unexpected illnesses and accidents that require medical care because the last thing you want to worry about when in the hospital is exuberant medical bills and pesky collectors – and we are sure you’ve heard the stories about the people who received bills for hundreds of thousands of dollars (or even a million) after a hospital stay.

And although college-aged individuals tend to be healthier overall, there are certain areas of concern among this group – specifically being mental and sexual health. Depression and anxiety-related concerns have risen dramatically among the younger generation over the years, and the pandemic has only made things worse – which is why we ensure that you have access to the BEST care and comprehensive services for behavioral health, not just physical.

We have also recently seen outbreaks of COVID-19 cases among college students who have recently gone back to campus – although the risk of life-threatening complications is less, why would you want to risk it during a pandemic? At the end of the day, we just want you to be healthy, we want to see you graduate, and we want to see you succeed. That’s why we want you to have health insurance.

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