Wellfleet Student exists for the primary purpose of serving students’ needs through high-quality, affordable health insurance for students. That mission feeds into everything our student health plan does, which is why we take healthcare affordability so seriously.
College students have many responsibilities, and paying for healthcare should not be a burden. To proactively help our members and schools, we set an intentional focus on evaluating claims to ensure they’re accurate and students are not being overbilled.
Read on to learn how our team uncovered $67,790 in savings by fixing a billing mistake for a student hospitalized for meningitis.
The case study: battling meningitis
One of our student members enrolled in a Wellfleet Student Health Insurance Plan was hospitalized for meningitis, which is an infection of membranes surrounding the brain.1
The symptoms of meningitis in adults can include:
- Neck stiffness
- Sudden high fever
- Headache
- Nausea or vomiting
- Seizures
- Confusion
- Sometimes a skin rash1
Meningitis can have several causes, such as viruses or bacteria.1 Viruses are the most common cause of meningitis.2 This student was tested to determine which kind was causing their infection. Knowing this information helps set the plan for treatment.
However, bacterial testing requires a culture, which can take several days to complete. Therefore, in the meantime, the patient was given a precautionary treatment of antibiotics, an antiviral, and steroids, which helped the patient recover well enough to return home.
A second hospital stay
The day after the patient was discharged, the test results came back, showing that the patient had a viral form of meningitis called zoster meningitis. This type of viral infection is caused by reactivating varicella zoster virus (chicken pox).2
To treat this form of meningitis, the student needed to return to the hospital for a short stay to receive the additional treatment of an intravenous antiviral medication called acyclovir.3
The student was able to return home the following day and made a smooth recovery.
How Wellfleet’s team uncovered incorrect billing
When the bill for the student’s hospital treatments arrived at the desk of Wellfleet’s Clinical team, we found a major issue. The bill for the treatment was divided into two separate claims, even though standard practice at this hospital dictates that if a patient is readmitted for the same condition so quickly after being discharged, the hospital visits should be combined into one claim.
Because of this error in billing, the hospital charged far more for the student’s care than would have been the case if it had been correctly billed as one claim. In fact, between the two hospital stays, the student’s bill was $67,790 too high.
To amend this mistake, our Clinical team combined the two hospital stays into one claim and paid the hospital the correct reduced amount.
Other than looking for billing errors, what are other ways Wellfleet saves money? Here are three strategies we use to lower costs for clients and members.
How our billing scrutiny benefits schools and students
Wellfleet’s Clinical team thoroughly reviews claims like the one presented in this case study. We pay close attention to ensuring claims are correct because billing mistakes can result in a significantly higher cost of care, which may lead to higher out-of-pocket costs for members. We can often reduce the amount the student needs to contribute by reducing the bill.
Additionally, schools benefit significantly from our attention to detail with claims. That’s because each school’s premiums depend on the prior year’s spending. Thus, decreasing the amount of dollars Wellfleet pays toward a student’s claims leads to savings in the following year’s premiums. Savings in premiums mean more affordable health insurance for students, making quality healthcare possible for more people.
Interested in another savings story? See how we saved a school plan $210,000 by catching billing mistakes on the birth of twins.
Create a health plan built for your students
Now that you know about Wellfleet’s dedication to creating affordable health insurance for students, learn more about our student-centric health plans. Contact our Sales team to see how we can create a tailored student insurance plan for your campus.
References
1 Mayo Clinic Staff. (2023, January 27). Meningitis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508.
2 CDC. (2021, May 25). Viral Meningitis. Centers for Disease Control and Prevention. https://www.cdc.gov/meningitis/viral.html.
3 Taylor, M., & Gerriets, V. (2023, May 7). Acyclovir. NIH National Library of Medicine StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK542180/.
