1. While at WWU how do I see a health-care Provider?
Patients are seen by appointment (walk-in visits are limited). You may call CHW at 509.527.2425 and speak to the receptionist who will schedule your appointment.
If the appointment is not soon enough for you due to the urgency of your situation, the receptionist will transfer you to speak to a nurse who will evaluate your condition. The nurse will then make arrangements for you to be seen sooner if possible or refer you to an urgent care clinic or the emergency room if necessary.
2. How much will it cost me to be seen at Campus Health & Wellness?
All nurse or nurse practitioner visits to Campus Health & Wellness are provided at no cost to the currently enrolled student. There are charges for doctor visits, physicals and lab tests.
3. Can I bill any of the Campus Health & Wellness charges to my Walla Walla University account?
Prescriptions, labs, physical exams, and the optional sickness & additional accident premium may be charged to the student's account.
4. What if I want to see my primary care provider in my hometown for care?
Doctor's office visits will not be covered by the insurance unless: 1) referred by Campus Health, or 2) Campus Health & Wellness is closed. If student is ill after-hours, some providers do require a referral after the fact. A referral is not necessary for insurance to cover the visit.
The CH&W refers patients to specialists only after the patient has been evaluated for their concern at the CH&W and referral is indicated.
5. When is the Campus Health & Wellness open?
6. Who do I contact after hours?
We highly encourage each student to be seen in the clinic at the early onset of an illness. However, if an illness or accident occurs after hours, we encourage you to.
- Contact your Dean, if needed, they will contact the clinic personnel.
- Go to the Emergency room, We are contracted with Walla Walla General Hospital for emergency care.
Walla General Hospital
1025 S. 2nd Ave
Walla Walla, WA 99362
- Call 911 if the situation is life threatening
7. Who can I contact if I have an administrative or non-clinical question?
Wanda Nelson, Director ................. (509) 527-2425 Or by email, firstname.lastname@example.org
Gail Stolz, Insurance and Billing ..... (509) 527-2425 Or by email, email@example.com
8. What do I do if I need some blood work or other laboratory services?
Some diagnostic tests can be done in the CH&W clinic. Others are obtained and sent to Walla Walla General Hospital for results.
9. What about prescriptions?
We provide some frequently used medications in the CH&W clinic. CH&W can also write a prescription for you to take to the pharmacy.
10. What if I need a prescription filled before I get home to my regular doctor?
The CH&W is usually able to accommodate you. You will need to call CHW and schedule an appointment to talk with the nurse practitioner about your prescription needs.
11. As a patient what are my rights and responsibilities?
PATIENT RIGHTS AND RESPONSIBILITIES
THE PATIENT HAS A RIGHT
* To be treated with respect and dignity and be provided with courteous, considerate care;
* To be informed about the diagnosis and treatment of the health problem in terms that can be understood;
* To know the chances that treatment will be effective and to know the possible effects and alternatives;
* To receive confidential treatment of disclosures and medical records, except when required by law, be able to approve or refuse release;
* To know who is responsible for providing treatment;
* To have a second medical opinion before making any decisions, and to refuse treatment, but must be informed of the risks of refusal;
* To participate in decisions regarding health care;
* To be informed of the personal responsibilities involved in seeking treatment and maintaining health and well-being;
* To privacy;
* To have access to information concerning health education, self-care, and prevention of illness.
THE PATIENT HAS A RESPONSIBILITY
* To inform the practitioner of any changes in their health status that could affect treatment;
* To adhere to the prescribed treatment plan and discuss any desired change;
* To act in a considerate and cooperative manner with the Health Service staff;
* To ask questions and seek clarification regarding areas of concern;
* To weigh the consequences of refusing to comply with instructions and recommendations;
* To assist the practitioner in compiling a complete health record by authorizing health Services to obtain necessary medical information from appropriate sources;
* To keep appointments on time;
* To cancel appointments only when absolutely necessary, and far enough in advance so that other patients might utilize that time.
1. What is my policy number for Student Accident or Mandatory Health and Additional Accident Insurance?
When a student signs up for the Mandatory Health and Additional Accident Insurance, they will be sent an insurance card with their individual membership number. The card should arrive about 2-3 weeks after you have signed up for the school insurance. This card should be carried on you at all times. If you loose your card you can call CHW for a temporary card until your replacement card arrives.
The policy numbers are:
Accident only #US001201
Mandatory Health and Additional Accident Insurance #US001200
2. Must I be referred by Campus Health & Wellness for services received off-campus?
Under the Mandatory/Waiver Student Sickness and Additional Accident Insurance Plan, the student must use the resources of CH&W first. There, the treatment will be administered, and/or a referral issued. A referral issued by CH&W must accompany the claim when submitted.
A CH&W referral for outside care is not necessary under the following conditions:
1. Medical Emergency. The Student must return to CH&W for necessary follow-up care;
2. When CH&W is closed;
3. When service is rendered at another facility during break or vacation period;
4. Medical care received when the student is more than 20 miles from campus;
5. Medical care obtained when a student is no longer able to use CH&W due to a change in student status; or
Dependent spouses and children are not eligible to use CH&W; Therefore, they are exempt from the above limitations and requirements.
3. Does the referral requirement also apply to psychiatric benefits?
Yes. In order for psychiatric benefits to be covered for visits to an outside provider, you must have been fully evaluated and a referral must have been given by the WWU Counseling & Psychological Services for you to see that provider.
4. Am I covered by this insurance when I am away from WWU?
Yes. The Mandatory Student Health and Additional Accident Insurance is valid anywhere in the United States. Claims received for care outside of the Walla Walla area are treated the same as those submitted for local care.
5. What is my deductible?
Student Accident Insurance: $0 deductible
Student Health & Additional Accident Insurance:
$100 deductible per policy year (Deductible waived only for CHW visits)
Co-pays do not apply towards the deductible
$15 physician visit (Co-pay waived at CHW)
Co-pay on prescription medications ($10 generic/ $20 preferred brand/ $30 non preferred brand)
Participating provider: 80% of negotiated charges
Non-participating provider: 60% of reasonable & customary
6. Can you summarize my coverage as a student enrolled in the Mandatory plan?
A) WWU Provided Accident - up to $3,000 per incident. (Reminder: This covers most accidents on campus and campus owned housing during the school year or term for which they are enrolled. It does not cover accidents occurring off campus, with the exception of University sponsored activities. Please see Exclusions Section in the Insurance Brochure.)
B) Mandatory Health and Additional Accident - Pays on a scheduled fee basis of up to $50,000 or $250,000 (depending on coverage selection see brochure) of Covered Expenses incurred. The Mandatory Coverage is provided only to those students paying the insurance fee.
This Mandatory/Waiver Sickness and Additional Accident Insurance Plan provides an additional aggregate maximum of $50,000 or $250,000 for covered medical expenses, in excess of the $3,000 paid under the Student Accident Insurance Program.
When an insured person receives medical treatment by a licensed Physician because of accidental bodily injury or sickness incurred while insured hereunder and for which treatment is received within 90 days of said injury or sickness (the manifestation of which commenced while insured hereunder) the Company will pay the Usual and Customary Charges and medically necessary expenses incurred within 52 weeks from, date of injury or date of first treatment for Sickness, not to exceed the aggregate maximum of $50,000 or $250,000 per injury or sickness, as described under Schedule of Benefits .
7. What are the Mandatory Insurance fees?
Cost per academic term for the policy applied for:
Policy amount: $50,000 / $250,000
09/01/08 to 09/01/09 Annual $860 / $1,599
01/05/09 to 09/01/09 Winter $735 / $1,357
03/30/09 to 09/01/09 Spring $514 / $927
06/23/09 to 09/01/09 Summer $319 / $532
DEPENDENTS: For rates and enrollment information contact:
Wells Fargo of California Insurance Services
11017 Cobblerock Dr, Suite 100
Rancho Cordova, CA 95670
All enrolled, tuition paying, graduate and undergraduate students on the College Place, Missoula, Portland, or Rosario campuses, and students in the summer work program, are provided $2,000 coverage under the Student Accident Insurance Program and are eligible to participate in the Mandatory/Waiver Student Health and Additional Accident Insurance Plan. Adventist Colleges Abroad Students and Student Missionaries are excluded from coverage. Students must actively attend classes for 45 days following the date of enrollment in this insurance program, with the exception of Task Force workers within the U.S.
Eligible students may also purchase dependent coverage under the Mandatory/Waiver Student Health and Additional Accident Insurance Plan by contacting Wells Fargo of California Insurance(800) 853-5899. Eligible dependents are the spouse and unmarried children under nineteen years of age who are not self-supporting, and reside with the Insured Student. All newborn children of any Covered Person are automatically covered at birth for 31 days for an injury or Sickness (excluding routine hospital, nursery, and physician charges). Coverage may be continued for that child when the company is notified in writing within 31 days from the date of birth and by payment of any additional premium. Dependent eligibility expires concurrently with that of the Insured Student. Dependents are not eligible to utilize the CH&W.
ANY MEDICAL COSTS NOT COVERED BY THIS INSURANCE PLAN ARE THE FINANCIAL RESPONSIBILITY OF THE STUDENT.
8. When are all students required to purchase the Mandatory Student Health and Additional Accident Plan, unless they can provide proof of coverage within 20 miles of the college?
Before final registration clearance, you will need to show proof of private insurance or purchase the Mandatory Student Health & Additional Accident Insurance Plan.
9. Do I have to fill out a form every year?
YES. Because we often change insurance carriers to obtain the best insurance. Also, insurance plans for students covered under their parents' policies change frequently.
10. Will I receive a card for Mandatory Health and Additional Accident to show that I am covered?
Yes. The insurance company will issue a card acknowledging your enrollment. To provide proof of coverage in the event of an emergency you should carry this card at all times. A new card will be mailed to you each year.
11. Can I get a refund if I decide I don't want the coverage?
No. Once the premium is paid there is no refund except when entering military service.
12. In general, what services does the insurance cover?
To view the Schedule of Benefits click on the link below.
13. Is there any dental coverage?
Only if there is an injury to sound natural teeth (teeth that have not been restored).
14. As a student, how are pre-existing conditions covered by the policy?
A pre-existing condition is covered after 90 days. A pre-existing condition is defined as any condition which you sought medical advise or treatment three months prior to the effective date of the policy.
15. What are the maternity benefits? What about the baby?
Maternity expenses are treated by State Law the same as expenses for any other condition. Claims for pre-natal care may be submitted before the delivery and will be paid according to Fee Schedule. Sick infant care is covered the same as any other sickness for 31 days.
16. How do I file a claim?
FOR INJURIES OR ILLNESS:
1) Report at once to Campus Health & Wellness so that proper treatment can be prescribed or referral given. If away from school, consult a Physician and follow his/her advice.
2) Obtain an Insurance Claim Form from Campus Health & Wellness or from A-G Administrators at the address below.
3) Send signed and completed claim form, including Insured’s address, social security number, name of school, and all itemized hospital and medical bills to:
P.O. Box 979
Valley Forge, PA 19482
4) For status of a submitted claim or payment of a claim, contact A-G Administrators at the address above.
Questions regarding benefits?
Contact Wells Fargo of California Insurance Services at: (800) 853-5899
Claim forms must be submitted within 90 days of injury or first treatment for sickness or as soon as reasonably possible.
17. Will Campus Health & Wellness file a claim for me?
Yes. Claim forms for any condition must be completed by the student however, claims must be filed within 90 days.
18. What does the insurance cover for prescriptions?
PRESCRIPTION DRUG PLAN
This plan includes a drug benefit through Caremark for prescription services throughout the United States. A listing of contracted pharmacies and services is available at Caremark Customer Service at 1-800-777-1023, or on-line at www.caremark.com
Caremark offers two options for filling your prescriptions:
Option One is to have your prescription filled at a participating pharmacy. To find a pharmacy near you, please refer to the Caremark online pharmacy locator, www.caremark.com. To have your prescription filled at a participating pharmacy, simply present your ID card (the same ID card you use for medical care) to the pharmacist. You can receive up to a 30-day supply of most medications. You will be responsible for the co-payment and any co-insurance percentage that applies to eligible prescriptions.
Option Two is to have your medication delivered to your home using our convenient mail service program, Caremark. This is a great option if you have a maintenance medication or a medication that you are taking for an extended period of time.
If you need a prescription before you have received your ID card, call Wells Fargo Insurance (800-853-5899). We will verify eligibility and provide you with an ID number to take to the pharmacy. Otherwise, you may pay for the prescription and submit the receipt (which must include date, prescription, dosage, quantity, and amount paid) with a claim form to Caremark for reimbursement. A claim form is included with your ID card package, and may be downloaded from ww.pharmacare.com. Your reimbursement will be at the discounted participating pharmacy rate, less your co-pay. You will be responsible for any difference between the discounted pharmacy rate and the actual purchase price of the prescription.
The Caremark website is dedicated to providing you information about your prescription plan, mail service and answering many frequently asked questions about pharmacy benefits. The site provides the following:
E-mail Caremark Customer Service
Online Health Library
Formulary Counselor allows members to see customized descriptions of medications, which includes important drug information, classification and formulary status. It also provides patient specific plan and co-pay information, alternative treatments, and other data designed to help the member better understand his/her treatment and how it fits into his/her health plan.
Last update on June 29, 2009