|
WHAT YOU ARE CHARGED FOR CARE BY HUP/UPHS
|
|
|
If you have PSIP
|
If you pay Clinical Fee
|
|
Emergency Room visits
|
ER co-pay is $75
(no referral needed for ER visits)
|
· Billed to you or your insurance plan. Coverage is subject to terms of your insurance plan.
· You are responsible for payment of any co-pays or co-insurance your insurance plan sets.
· If UPHS is not in your insurance plan network, you are responsible for any charges not covered by your policy.
|
|
· Hospitalization ($100 co-pay)
· Surgical procedures ($150 co-pay)
· Consultations (specialist visits)
· X-rays and other imaging studies
· Lab tests
· Physical therapy (10% co-insurance)
|
Referral from SHS is required for most services outside of SHS (including ER follow up care)
· Charges billed to PSIP first
· After PSIP processes claim, UPHS bills you for charges that are your responsibility
· You pay first $250 of allowed charges every year (your deductible)
· Once deductible is met, you pay $25 for office visit and $35 for diagnostic tests; plus any applicable co-pays
|
FOR QUESTIONS ABOUT YOUR HOSPITAL BILL
Call 1-800-406-1177
FOR QUESTIONS ABOUT THE PENN STUDENT INSURANCE PLAN
Call the Student Health Insurance office at 215-746-3535, option 3
|
