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Billing and Insurance

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Billing and Insurance


Insurance Types

OUHS is an In Network provider with the CIGNA Health Care plan. OUHS is contracted with many other major insurance companies and will file most insurance with a U.S. address, even if we are not contracted or are out-of-network with the plan. However, this does not guarantee that the insurance company will cover all the costs of services.  Only your insurance can tell you if specific services are covered and will be paid. You should call the insurance company and discuss your coverage with them if you have questions about your out-of-pocket costs. Please be sure to check with your insurance company to see if OUHS is “in” or “out” of network with your plan. 

Student Health Fee

The student health fee is included in the Mandatory Fees paid each semester/summer. The health fee allows OU Health Services to provide quality health care including office visits at discounted rates and other additional services to students. Students who are not enrolled in summer classes, and therefore not charged a health fee, can choose to pay a reduced summer health fee to continue utilizing the health center’s services.

Charges

The financial responsibility for most office visits is discounted to between $15 and $35 depending on the level of care. Additional charges may include: medications, supplies, diagnostic tests, procedures, etc. used or performed as part of an office visit. .

Insurance

OUHS is contracted with many major insurance companies and will file most insurance with a U.S. address, even if we are not contracted or are out-of-network with the plan. However, this does not guarantee that the insurance company will cover all the costs of services. Only your insurance can tell you if specific services are covered and will be paid. You should call the insurance company and discuss your coverage with them if you have questions about your out-of-pocket costs. Please be sure to check with your insurance company to see if OUHS is “in” or “out” of network with your plan.

Students are responsible for any copayments, coinsurance, and deductibles as defined by your insurance plan. Many preventative services like physicals, some immunizations, and annual exams should be covered 100% by an insurance company due to the Affordable Care Act.

We will need the following to file your charges with insurance.

  • a copy of your insurance card (front and back)
  • a completed copy of the insurance forms

You may submit this information by:

  1. Uploading documents to HealthConnection (you will need to register for an account (pdf))
  2. Scan and email* to goddard@ou.edu.
    *Please note the security of email transmissions cannot be guaranteed and that unauthorized individuals may be able to access the message.
  3. Drop off at OUHS: 620 Elm Ave. Norman, OK 73019
  4. Mail: OU Health Services, 620 Elm Ave., Norman OK 73019
  5. Fax: 405-325-7065
    Note: Please include Student ID number on all documents.

Is OU Health Services-Goddard Health Center in-network with my insurance?

What does this mean? The doctors, hospitals, and suppliers your health insurer has contracted with to deliver health care services to their members. If you choose a doctor who is out-of-network, and not a partner with your insurer, you may have to pay part or all of the bill yourself.

Contact your insurance company customer service line to see if we are in-network providers for your plan. This number is usually found on the back of your card. Please be aware that you will not find any of our providers in an online search of your insurance directory. We are “directory suppressed” because we only see patients affiliated with the University.

Be prepared to ask these questions:

  • Does my insurance pay for health care services provided by OU Health Services-Goddard Health Center?
  • Is OU Health Services “In” or “Out” of network with my insurance?
  • Will I need a primary care provider’s referral in order for my insurance to pay for care at OUHS?

Be prepared to answer these questions:

  • Facility Name We are listed as Board of Regents, The University of Oklahoma, OU Health Services.
  • NPI number of our facility Our facility NPI # is 1548372626.
  • Provider name and NPI number You may use Craig Rice, MD as a sample provider (NPI # is 1932175320).
  • Address 620 Elm Avenue, Norman OK, 73019.

The University offers a health insurance plan for students. This may be an excellent option for students who may not have insurance coverage or whose out-of-state insurance only covers emergency visits in the Norman area.

OU Health Services-Goddard is the primary service provider of the plan, but we are not the plan administrators. This means we can’t always tell you if your charges are covered by the SHP or how much your out-of-pocket costs will be. However, most students have little to no out-of-pocket expenses with visits at OUHS-Goddard (benefit coverage does change when receiving care outside of OUHS-Goddard). More information about the student health plan can be found here.

You do not need health insurance to use OUHS. With a few exceptions, your financial responsibility for most office visits is between $15 and $35 depending on the level of service. Additional charges apply for any tests and treatment ordered by your healthcare provider. If you don't wish to pay on the day of your appointment, we will bill your charges to your bursar.

Information about Tricare

Please Note: We are not in the Tricare Prime Network.

Student Health Services does accept TRICARE. It is up to the student to ensure the following for it to be accepted:

  1. Have your primary care provider (PCP) changed to a Student Health Services Provider. If you do not know the name of a preferred provider please select: Craig Rice, MD (NPI # is 1932175320).
  2. Call your primary care provider (PCP) and ask them to request an authorization for you to be seen at Student Health Services for either the visit or for the entire semester. Give your PCP the name Craig Rice, MD (NPI # is 1932175320).

This will need to be done before each semester to use your TRICARE Prime at Student Health Services.

If TRICARE denies the claim, the bill will be converted to self-pay at the student rate and the charge will be billed to your bursar account. Often Tricare will require a student to seek care at Tinker Air Force Base due to its close location to Norman.

Information about Health Maintenance Organization (HMO) plans:

  • OUHS does accept HMO plans. HMO plans typically do not pay for services at OUHS. However, if you have an HMO plan, call your primary care provider (PCP) and ask them to request an authorization for you to be seen at OUHS for the entire current (or upcoming) semester. Give your PCP the name Craig Rice, MD (NPI # is 1932175320).
  •  You must do this before each semester.
  • Students with an HMO plan who have not received authorization to be seen at OUHS (and therefore the insurance claims are denied) will receive the discounted student rate.

Insurance FAQs

Not necessarily. If we bill something to your insurance where the parent or family member is the policy holder, they will have the ability to see the services from the insurance company’s Explanation of Benefits (EOB). It is important to note, however, that if a parent or anyone other than the patient calls and asks OUHS about a patient visit, we will not disclose information about your visit to the health center or test results - unless you have signed a written authorization for us to release information.

If you do not wish to use insurance for your visit, you must complete a “Financial Responsibility” form, and you will need to pay for the visit in full at the time of service.

We cannot tell you if your insurance will cover a specific service. Payment by insurance is never guaranteed.  You must contact your insurance company to see what your benefits cover and if they will be covered at OUHS. We can tell you what the price will be without insurance or if insurance does not cover the service. The Patient Services Office can provide you with pricing for specific lab tests, services and procedures.

The financial responsibility for most office visits is between $15 and $35 depending on the level of service. There are additional charges for all medications, supplies, diagnostic test, procedures, etc. used or performed as part of an office visit. 

If you choose to not pay at time of service, all charges will be sent to your bursar account. 

Laboratory and radiology services performed at OUHS will be billed in the same manner as a physician visit (insurance or self-pay) and will receive the same financial benefits as all of our services. 

Certain lab tests cannot be processed at OUHS and must be sent to our contracted reference lab, LabCorp/RML. Some insurance plans and some lab tests require the reference lab to bill your insurance directly. If you are concerned with your out-of-pocket costs, please ensure that LabCorp/RML is in network with your insurance before having lab tests performed. The phone number to contact LabCorp/RML is 1-800-722-8077. 

Student Health Plan FAQs

  1. Visit OU Health Services First
    Always go to OU Health Services-Goddard first when you need non-emergency medical care.  Health Services is located at 620 Elm Ave., Norman, OK. The phone number for appointments is (405) 325‐4441. The main phone number is (405) 325-4611. 

  2. Get a Referral 
    If OU Health Services-Goddard cannot provide the services you need, they will refer you to a preferred provider. If you have previously discussed the referral with one of our providers during an appointment, you can message that provider on Health Connection.  

IMPORTANT-If you visit a provider outside of OU Health Services-Goddard, your cost will be higher and may be subject to your deductible. For more information, see the plan brochure on the Academic Health Plans website. 

  • Go to Urgent Care – Find an in-network urgent care facility when OU Health Services-Goddard is closed by clicking on "Find a Doctor or Hospital" in the right column of the Academic Health Plans website. Urgent care is for treatment of a medical condition needing immediate attention. According to the Urgent Care Association of America, urgent care services often serve as a direct link between the public and emergency room services. Examples could include: care for flu, lacerations, stitches, animal bites and so forth.
  • Go to the Emergency Room – You should only visit a hospital emergency room when the illness or injury could cause serious long term damage to your health if not immediately treated.

If you have questions about referrals, please call (405)325-1826. Be prepared to leave a message with your name, date of birth, Student ID number and the question(s) you have.

 

If you were a student during the spring semester, then you are allowed access to OU Health Services-Goddard during the summer. On your first visit of the summer, you will be charged the Student Health Fee that is normally part of regular tuition and fees.

A referral is an authorization required by some insurance plans that members obtain from their designated primary health care provider.  OUHS-Goddard is the primary health care provider for the OU Student Health Plan on the Norman Campus.  

While the SHP insurance (BCBS) does not require an insurance referral for specialist visits, it is important to note that many specialists require a medical referral from a primary care doctor, as it can facilitate a more coordinated and comprehensive approach to healthcare.

 

Common Insurance Terms

TermDefinition
ClaimA request by either the plan customer (you) or a plan customer’s healthcare provider (your PCP), for the insurance company to pay for medical services.
CoinsuranceYour share of the cost for a covered health care service, usually calculated as a percentage (like 20%) of the allowed amount for the service.
Example: After you meet your deductible, then you pay part of the bill (say 20%) and your insurance pays part of the bill (say 80%) until you've paid your total out-of-pocket for the plan year. Some plans then pay 100% of your allowed medically-necessary costs
Copayment (Co-pay)An amount you pay as your share of the cost for a medical service or item, like a doctor's visit.
DeductibleThe amount you owe for covered health care services before your health insurance or plan begins to pay. Example: With a $1000 deductible, you pay the first $1000 of costs yourself. After that, the company starts to pay its share.
Explanation of Benefits (EOB)An EOB is a statement from your health insurance plan describing what costs it will cover for medical care.  It usually lists the amounts charged, amounts the insurance allows, what the insurance will pay and your financial responsibility. The EOB is generated when your health care provider submits a claim for the services you received. An EOB is typically mailed to the policy holder’s home address. It can also be available online, and a copy is made available to the health care provider
Health Maintenance Organization (HMO)A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage.
Example: Kaiser Permanente HMO
Why does this matter? HMO plans use a specific network of providers. If you choose a doctor who is out-of-network, and not a partner with your insurer, you may have to pay part or all of the bill yourself.
NetworkThe doctors, hospitals, and suppliers your health insurer has contracted with to deliver health care services to their members. If you choose a doctor who is out-of-network, and not a partner with your insurer, you may have to pay part or all of the bill yourself.
Out-of-pocket CostsYour expenses for medical care that are not reimbursed by insurance.  This could include copays, deductibles, and coinsurance for covered services and costs for services that are not covered.
Primary Care Provider (PCP)The PCP is typically your first point of contact for all health-related care. This can mean that a person cannot see a specialist without first having a referral from their PCP. This is mostly seen with Health Maintenance Organizations (HMO).
ReferralA referral is an authorization required by some insurance plans that members obtain from their designated primary health care provider.  OUHS-Goddard is the primary health care provider for the OU Student Health Plan on the Norman Campus.