Student Accounts & Billing

About Student Accounts & Billing

Each patient is given a copy of medical charges incurred on the date of service that is suitable for insurance filing, personal record, or excused absence purposes. Student Health Services does not file insurance claims on behalf of the patient. The patient is responsible for payment of medical charges regardless of health insurance filing status. Outstanding medical charges may interfere with your graduation status, successful registration for subsequent semesters, or requests for transcripts.

If you need additional copies of your medical charges, please follow the guidelines below. If you need copies of your entire medical record, please direct all inquiries to:

Student Health Services
Anna M. Gove Health Center
Post Office Box 26170
Greensboro, NC 27402-6170

Obtaining Copies of Your Medical Charges

Protecting Patient Privacy is a High Priority!
Protecting patient privacy is a high priority at Student Health Services. Due to federal regulations, we are not permitted to discuss your medical information over the telephone. Additionally, we can only discuss this information with you, the patient, and not your parents (unless you are under the age of 18), family members, spouse, or friends. If you need copies of your billing and pharmacy records, it is your responsibility to request the information. This can be done:

In Person:

Stop by The Insurance Offices – Rooms 154 & 155 – on the first floor of Gove Student Health Center to request copies of billing and pharmacy charges. Be sure to bring one form of photo identification — drivers license, UNCG Student ID, UNCG SpartanCard, etc. You will be asked to complete the Authorization for Use and Disclosure of Protected Information Form (available below). Once this is complete and your photo identification has been verified, we can often assist you right at that moment for one or two copies. Otherwise, you will be contacted when the information is ready for pickup or it will be mailed to you.

By Mail or Fax:

Once you have completed the Authorization for Use and Disclosure of Protected Information Form (available below), you may either mail or fax it to:

Student Accounts Receivable Office
Student Health Services
Anna M. Gove Health Center
Post Office Box 26170
Greensboro, NC 27402-6170
FAX: (336) 334-5357

Once we receive your completed form, we will compare your signature with a signature on file in your medical record. If the signatures are verified, copies will be sent to the address indicated on the Authorization for Use and Disclosure of Protected Information Form (available below). If the signatures do not appear to match, we will request additional information from you to verify the authenticity of the request.

Downloads

Authorization for Use and Disclosure of Protected Health Information Form

Please note: some items require the Adobe Acrobat PDF Reader, which can be downloaded from the Adobe web site.