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At American University, the health and wellness of the student population is of utmost importance. All full-time degree, resident and international students with F1 and J1 visas are required to have health insurance, which the Washington, D.C., based university offers to cover accidents and sickness that occur both on and off campus. As part of its commitment to providing students with the most affordable, cost-effective benefits plan, along with a broad network of providers, AU recently signed on with GM Southwest, a Frisco, Texas-based provider of school-sponsored student insurance plans.

Students access their health care benefits through AU's on-campus Student Health Center, which provides primary care medical services, health education and wellness programming, including routine exams, allergy injections and immunizations.

"The Student Health Center serves as a staff model HMO, managing health care services like a primary care physician," explains Clint Jackson, national director of sales and marketing for GM Southwest. "If a student requires additional medical care outside of the Student Health Center, they are referred directly to the appropriate outside medical provider or specialist."

GM Southwest works closely with medical technology partner VIIAD Systems LLC of Langhorne, Pa., to direct students to the appropriate, network-based providers. Using VIIAD's technology, students are able to go online to print an automated Health Ticket, which serves as a health care ID card that identifies all of their pertinent benefits information. Similar to an airline eTicket, the Health Ticket contains personalized, member-specific information such as copay instructions, deductibles, provider information, pre-certification requirements, and pharmacy benefit information. In addition, the Health Ticket clearly states whether a chosen provider is in or out of network, so students can obtain the proper authorization prior to visiting a doctor.

"This technology gives patients, payers and providers access to health care information on an on-demand basis," says John Zubak, chairman and CEO of VIIAD, which stands for Virtual Interactive Identification and Direction. "The Health Ticket becomes a virtual insurance card that improves compliance, eliminates fraud and provides administrative savings to providers and physicians, and offers simplicity for patients," he notes.

"The Health Ticket communicates the benefits available prior to point of service every time," says Jackson. "Students are notorious for throwing things away. This technology puts the information they need at their fingertips at a moment's notice. They can print a new Health Ticket each time they need medical services, go online anytime to confirm their benefits and provide physicians with eligibility, billing and pre-certification requirements with the click of a button.

"In addition," says Jackson, "we're able to provide campus medical professionals with the ability to identify any gaps in coverage and manage the continuity of care across all providers. Because benefits tend to be allocated for students--similar to defined benefit plans in the traditional health care arena--we're able to conserve students' benefit dollars and reduce their out-of-pocket expenses."

While AU has only been using the new benefits program since mid-August, Bruey is already reporting positive results. "Students have been very satisfied with the plan, especially with regards to the technology piece and the ability to access their benefits information whenever they need it. Students are now more aware of what providers are in network and who is out of network--which avoids confusion when they need to go to the doctor. In addition," he says, "the Health Ticket provides a snapshot of the student's benefit level, which helps them understand their financial obligations and gives them the confidence to use their medical services to their advantage."

Adds Bruey, "We believe we're teaching our students to become advocates of their own health care and educating them for real world experiences--a task which has been made easier through the use of this new technology and the access to information on which to base their medical decisions."

(The above piece is part of our continuing Insights series designed to highlight key products and services to our readers. This paid-for Insights was written and edited by Risk & Insurance® on behalf of our marketing partner. Additional Insights can be found on our Web site at www.riskandinsurance.com/.)

November 13, 2008

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