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Frequently Asked Questions

How can my SBHC program improve consent and insurance status verification?

  • Obtain consent forms and student insurance information when the student first registers for the clinic. Verify this information at each visit and make updates as indicated.
  • Photocopy patients’ insurance cards or verify insurance status online.
  • Track renewal dates for patients’ insurance coverage. Prompt and support the patients to renew their coverage if needed.
  • Facilitate health insurance enrollment for uninsured students and families onsite or by referral to an outreach and enrollment specialist.

What do you recommend we do to improve our business practices around coding, billing, and collections?

  • Conduct in-service training for SBHC staff on CPT and ICD coding, Explanation of Benefits (EOBs), and billing/collection procedures.
  • Code all SBHC services provided and submit all claims promptly to payers to maximize insurance reimbursement.
  • Offer group visits and allow for one-on-one time between the patients and care provider (i.e., asthma, diabetes, healthy lifestyles, psycho-educational groups). Utilize group visit codes and submit for reimbursement.
  • Analyze any denied claims and resubmit corrected claims to payers.
  • Establish a separate SBHC cost center and post all expenses and revenue to it.
  • Report SBHC utilization data, expenses, and revenue from visits to SBHC staff monthly, and strategize how to decrease expenses and increase revenue.