EMPLOYEE DISCOUNT POLICY

Effective as of 07/11/01

SUMMARY OF POLICY

As a benefit to UICOM-R employees, providers and their immediate families, any unpaid balances remaining on medically necessary services provided by a UICOM-R provider will be reviewed for a discount. The amount of the discount will be based on whether or not the employee carries insurance coverage.

NOTE: It is mandatory that the providers keep a chart and records for every student or family member on every visit.

PROCEDURE

Who qualifies?

•  Current full time/part time employees and their immediate families. (Spouse and dependant children 22 years and under)

•  Current UICOM-R employed providers, full time/part time and their immediate families.

( Spouse and dependant children 22 years & under)

DISCOUNTS WILL BE OFFERED

BASED ON THE TYPE OF COVERAGE PRESENTED

A. Patients Covered By Insurance

100% discount on all co-payments and balances remaining after all third party payments have been received up to a maximum amount of $250 per person, per fiscal year.

• UICOM-R will discount balances after all appropriate payers have paid.
• Addendum approved 4/30/2004 : When a qualified employee, their spouse, or dependant child sees a UIC provider and their primary insurance denies payment due to the patient having a designated Primary Care Physician (PCP) outside the UICOM-R system, the MSP business office will conduct a review of the disputed charges. The review will determine if the employee or their spouse had requested a change, through their insurance company, to a UICOM-R PCP prior to the visit in question. If the insurance carrier has no record of the request for change, the employee cannot document the request, and the insurance company denies payment, then the patient will become responsible for all charges less a 25% discount. The total of any/all discounts given may not exceed $250 in any fiscal year. It is the responsibility of the individual office to have the patient sign the appropriate insurance documentation prior to seeing the provider.

B. Without Insurance

A flat discount of 25% of all the services received up to a yearly amount of $250 per person. Discounts will be taken upon payment of the remaining balance.

The UICOM-R MSP Business Office will manage the employee discount.

NOTE: Discounts will not be given for services considered cosmetic or non-medical in nature.

Medical supplies are excluded from this policy.