Benefits and Billing Questions

Enrollment and Eligibility Questions

Each School has dedicated staff to assist you with enrollment in the student health insurance and University Health Services.

UHS Benefits & Billing Office

The UHS Benefits & Billing Office is dedicated to assisting students and trainees with medical billing and/or claims questions. See our guide to definitions to health care terms you may hear at UHS.

Olha Gudesblat, Assistant Manager for Benefits & Billing
933 N. Wolfe St.
Baltimore, MD 21205
Phone: (410) 955-3872
Fax: (410) 614-3643
Email: okryvya1@jhmi.edu

Procedure for Claims Filing: For care not provided at UHS, either you or your provider (physician, hospital, lab, etc.) will need to file an insurance claim with your insurance company in order to receive benefits. In most cases the provider will file the claim for you. However, if your provider will not file the claim you will need to complete a claim form and send it, along with an itemized bill, to the claims department of your health insurance plan. Some providers require the subscriber to pay 100% of the bill at the time of service. The subscriber then needs to file a claim with the Student Health Program for reimbursement. The UHS Benefits Office will assist you in taking the appropriate action.

Billing Documentation: Once the claim has been filed, you may receive a bill and an Explanation of Benefits (EOB) from your health insurance plan for each physician office visit or service received. An Explanation of Benefits (EOB) is an itemized description of services that shows the total cost of the services, what portion was paid by the plan and if there is a member liability. These EOBs will say on them “This is not a bill. “ Do not throw away any EOBs. The service provider (physician, hospital, lab, etc.) may send you a bill for the balance once the insurance plan has made payment for services. The bill will be for the member liability as described in the Explanation of Benefits (EOB). The member liability is the portion that is owed after the insurance plan has paid the provider. This is a real bill and you need to make sure the balance gets paid.

Please note: You will not receive a bill for a visit to UHS. However, your spouse/ domestic partner may receive an EOB for a visit to UHS. UHS will be listed as the provider in the top right corner of the EOB. For visits to specialists, you may receive both an EOB and a provider bill.

Payment of Bills: Hold on to all EOBs and bills. If you receive any EOBs or bills, please review them carefully. Do not ignore them. If you have questions, contact your insurance company for further explanation on how the claim was processed. If you require further assistance with the matter, contact the UHS Benefits Office.

Bills for Wilmer Eye Exams: Provider bills (and EOBs if received) for routine eye examinations or contact lens evaluations obtained through the Wilmer Institute Comprehensive Eye Service should be forwarded to the UHS Benefits Office for payment of eligible expenses.

Important Points to Remember:

• It is the participant’s responsibility to understand what services are and are not covered by their health insurance and/or University Health Services prior to seeking care.
• Procedures and hospitalizations are generally covered by the insurance as a percentage of the reasonable & customary charges (see definitions section below). The UHS Benefits Office does not provide supplemental coverage for these services. The balance after your insurance payment, if any, is your responsibility.

Below are some typical questions the UHS Benefits Office will be able to address:

• I received a bill which I believe to be incorrect. What should I do?
• I am being told that I owe a balance, but I am certain that I have paid in full. What should I do?
• I have questions about my medical benefits and coverage. Whom should I address them to?
• I had to contact the Student Health Program (EHP insurance), but I was unable to address my issue. Who can help me with this?
• I am out of town or out of the country on an official Hopkins elective and I have to seek medical care. Who can help make sure that my medical expenses will be fully covered?