- Counseling Telehealth Consent Agreement
- COVID-19 In-Person Counseling Informed Consent
- Release of Information Form
- BSU Minor Consent Form
- Immunization Form
- Counseling Informed Consent
- Form Refusal Treatment
- Client Rights and Responsibilities – Medical
Cost and Insurance Billing
SCHC does not collect payment at the time of service, we bill most major insurance companies and if there are remaining charges, they will be placed on your Eservices account. If you have questions regarding the coverage on your insurance at SCHC you can contact your insurance company through the phone number on the back of the card.
Bring your insurance card to all of your appointments at SCHC, if you don’t have a physical card you can email the front and back of the card to firstname.lastname@example.org
SCHC uses Compu-Med billing services and if you have any questions regarding your bill through SCHC you can contact them at (701) 551-7513 or Maliyah.email@example.com.
If you choose to pay out of pocket, we offer a self-pay option at reduced rates. To obtain the self-pay agreement and charge list contact SCHC.
Here at the Student Center for Health & Counseling we accept many major medical insurances. Students with these insurance plans can have their charges billed directly by presenting a valid insurance card with policy information before appointment, or by emailing a picture of their insurance card to firstname.lastname@example.org
If you do not have insurance or have a plan we are unable to bill directly, you are responsible for charges. If we don’t currently bill to your insurance you may be able to submit the charges to your insurance company for reimbursement. Contact us if you have questions.
Common Clinic Charges for Self-Pay Option
- New Patient Appointments $50 – $120
- Established Patient Appointments $20 – $135
- Annual Physical/Preventative New Patient $100 – $110
- Annual Physical/Preventative Est. Patient $85 – $95
- Rapid Strep Test $17
- Urine Pregnancy $10
- Chlamydia/Gonorrhea/Trichomonas Screening $70
Good Faith Estimates
You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of their bill for health care items and services. If you schedule a medical service at least 3 business days in advance you can request this estimate in writing within 1 business day after scheduling. You can also ask for an estimate prior to scheduling. Learn more about healthcare consumer protections and email FederalPPDRQuestions@cms.hhs.gov or call 1 (800) 985.3059 if you have any questions.
Obtaining Health Insurance
Getting health insurance is complicated. If you don’t currently have insurance, there are resources in the community to help. MNsure is a marketplace to shop for insurance plans. Once a person completes an application, MNsure will show the options available for your circumstances. MNsure is available to US students. While international students are required to use United Healthcare insurance, international students can access MNsure to determine if their dependents are eligible for insurance.
Please contact our Case Manager for free assistance navigating health insurance resources contact email@example.com or (218) 755-2024.
Minnesota Family Planning Program
SCHC offers free birth control through the Minnesota Family Planning Program (MFPP). To see if you qualify you can access more information or you can schedule an appointment with our nurse practitioner. If you have questions about your application please call MFPP at 1-888-702-9968.
Understanding your International Student Insurance
- Please check your brochure of benefits to verify your office visit will be a covered service.
- United Healthcare Student Resources: Visit to print your insurance card, view claims and update your address.
- Depending on where you receive medical treatment, there may be differences in cost for the same services.
- Not all services provided at a medical facility are covered by your insurance plan. If you’re seeking non-emergency care, verify your benefits before you receive a medical service.
Locate a United Healthcare network provider/clinicnear you: United Healthcare provider search
- Select UHCSR options PPO
- Search for physicians/hospital
- Enter Search Criteria
- Select Specialty
- View Results