- 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.
- 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.
Frequently Asked Questions