Who is my insurance company?
If you have chosen to participate in the AU Student Health Insurance Plan, you are insured by GM Southwest. All claims are managed and administered by GM Southwest Claims Administrators.
Who is considered an in-network provider?
GM Southwest is a company that uses various carriers for their in-network providers. This helps to ensure greater coverage both locally and across the country should you move for a semester or return home for the summer. For coverage in DC, Maryland and Virginia, GM Southwest uses CareFirst Blue Cross/Blue Shield providers. Any provider in the CareFirst Blue Preferred (PPO) network will be a Preferred Provider. Outside the DC, MD and VA region you must use the online provider search at www.myaustudentinsurance.com. Click on “Provider look-up/Health Ticket” where the VIIAD network will locate in network providers outside the DC region.
Will I have to pay a deductible?
A "deductible" is the amount of money you must pay toward a medical bill before the insurance company pays. There is a $150 deductible per policy year (per person) when you see a GM Southwest Preferred Provider and a $200 deductible per policy year when you see a Non-Preferred Provider. If you visit both a Preferred Provider and a Non-Preferred Provider in the same policy year, you will have to pay both deductibles -- for a possible deductible maximum of $350 during the policy year.
How do I find an off-campus provider?
You have three options to find an in-network provider. 1) Visit www.myaustudentinsurance.com to find a provider using the online Health Ticket. 2) Call the Counseling Center and ask about the drop-in hours to see the Clinical Insurance Assistant who can provide information about referral resources both in and out of the preferred provider network. 3) Call the main number at the Counseling Center (202/885-3500) to schedule an intake appointment. This last option can be used if you would like to meet with a counselor for a more in depth assessment of your mental health needs and assistance with the referral process.
Do I have to come to the Counseling Center before I can see a provider in the Community?
No. There is no insurance referral/paperwork requirement that necessitates obtaining a referral from the Counseling Center before you access your mental health benefits through GM Southwest. If you would like assistance with finding a provider in the community however, you are welcome to speak with our Clinical Insurance Assistant during her drop-in hours, or make an appointment to speak with a counselor.
How will I know what my mental health benefits are and whether my claims to GM Southwest will be paid?
A referral to a provider from the Counseling Center does not guarantee that the private services you receive will be covered by your plan or that a claim for those services will be paid. You are responsible for reading your plan carefully and negotiating directly with your provider and with GM Southwest about your coverage and claims for private services.
What if I want to see someone who does not accept our insurance?
If you are on the AU Student Health Insurance Plan and you use a Preferred Provider (for the DC, MD and VA region this would be a CareFirst BC/BS provider), your out of pocket expenses will probably be less than if you use a Non Preferred Provider. However, your plan provides benefits in either situation. Whenever possible, your Center counselor will provide you with the names of Preferred Providers. If your counselor cannot provide you with the names of Preferred Providers, you can always find a Preferred Provider yourself through the GM Southwest website www.myaustudentinsurance. Please note that the Counseling Center does not monitor or guarantee the quality of off-campus providers. If you have any concerns about the quality of your off-campus care, a consultation with a Counseling Center counselor can help you to determine your next steps.
How do I arrange for my mental health bills to be paid?
If your private provider is a Preferred Provider, he or she is required to submit your bill/claim directly to the insurance company. In the DC, MD and VA region the CareFirst BCBS provider will submit the claim directly to BC/BS. Simply show your provider your identification card and they will submit the claim for you. If you see a Preferred Provider outside the DC, MD and VA region then the claim must be sent to the GM Southwest address in Newton, PA listed below.
If your provider is a Non Preferred Provider, it is up to your provider whether he/she will submit a claim or require that you do so. If your provider requires you to submit a claim, the claim form is available for you to download at www.myaustudentinsurance.com. Non Preferred Provider claims are to be sent to the GM Southwest address in Frisco, TX listed below. Keep in mind that the cost of most visits is shared between you and the insurer – you will pay a part of the provider’s fees and the insurer will pay a part. See your plan for details about your coverage.
When must claims be submitted?
Bills must be submitted within 90 days from the date of treatment.
What paperwork is required to submit a claim?
In-network providers are required to submit your bills/claims directly to the insurance company and these providers will manage this claim process. If you are filing an out of network claim, the claim form for this is available for you to download at www.myaustudentinsurance.com.
I still have questions – who do I contact?
Please see below for contact information.
CONTACT INFORMATION
To find a list of mental health providers that are in network go to…
www.myaustudentinsurance.com
To ask questions about your coverage or claims, contact GM Southwest Customer Service: 1-877-885-3298
For in network* claims for services rendered in the DC, MD and VA area….
CareFirst
P.O. Box 10104
Fairfax, VA 22038
For in network* claims for services rendered outside the DC, MD and VA region…
GM Southwest
P.O. Box 1740
Newton, PA 18940
1-877-885-3298
* In network providers in the DC, VA, MD region are from the BCBS Carefirst Blue Preferred network. In network providers outside this area may be drawn
from other insurance carriers. In network providers are required to submit their own claims.
Out of network claims for services (in or outside the DC, MD, VA region) should be sent to:
GM Southwest
P.O. Box 6000
Frisco, TX 75034
To ask questions about your student health insurance status…
Insurance Office, AU Student Health Center
(202) 885-3378
www.american.edu/healthcenter
To express concerns about your off-campus care, or obtain a referral to another provider…
Clinical Insurance Assistant, AU Counseling Center, Mary Graydon Center 214
(202) 885-3500
www.american.edu/ocl/counseling
