Determining your Benefits for Medical Care

Call the member benefits phone number on your health insurance card.

• Have your insurance card ready as you will need to provide basic demographic information.

If your insurance is not listed as In-network, please confirm your network status before being seen at UHS.

• Ask the customer service representative if University Health Services (UHS) is in-network. They may need to search using our tax ID: 746000203 or our address: 100 W. Dean Keeton St., Austin, TX 78712.
• If UHS is not in-network, the representative can help you find an in-network provider or inform you about out-of-network benefits.

Verifying Benefits for Other Providers

• Contact other doctors' offices or healthcare facilities directly to obtain their Tax ID or NPI number if you need to verify benefits for their services.

If You Haven't Visited UHS Yet

• Confirm your member benefits for the medical services you anticipate. Ask about your coverage for specific services, such as:
  • Office sick visits
  • In-office diagnostic labs
  • Physical therapy
  • Contraceptive coverage or family planning benefits

Note that health insurance carriers often need CPT and ICD-10-CM codes to provide precise benefit information. This information is sometimes unavailable before your visit but can guide you on expected costs for general service categories. Check your insurance plan booklet or online member portal for additional details.

If You Have Visited UHS

• Contact Healthyhorns Billing for CPT and ICD-10-CM codes related to the services you received. This is essential after your provider has documented your visit and/or ordered additional services.
• Provide these codes to your insurance representative to understand your financial responsibility, including:
  • Co-payment (fixed amount for the service)
  • Deductible (amount paid before insurance coverage begins)
  • Co-insurance (percentage you owe)
  • Check for Benefit Exclusions
• Ensure you understand if any services are excluded from your plan. Clarify with your insurance provider if you are unsure about any financial responsibilities for "covered benefits."

Document Your Call

• Before ending the call, request a call reference number or note the date, time, and representative's name. Keep this information in a safe place.

Appealing Claim Decisions

• If your claims are processed differently than quoted, you have the right to appeal. Use the call reference number or call details for the appeal process. Your health plan member services can guide you through this.
• By following these steps, you can accurately verify your benefits and understand your financial responsibilities for medical services.