Billable Services

Effective: September 1, 2019

While the majority of services available at the Health Service are free to students who are registered for classes and paying the health access fee, there are some services that have a fee associated with them.  Below is a listing of those services and the associated fee.

 

Office Visits & Physicals

  • Office visit (Registered) - $0
  • Office visit (Leave term and Part Time students) -  $100.00
  • Athletic physical - $100.00
  • DOT physicals - $115.00

Note: Patients will be responsible for any lab or x-ray fees associated with a physical.

Immunizations

  • Chicken Pox (Varivax/Varicella) - $183.00  
  • Hepatitis A (Havrix) - $77.00  
  • Hepatitis B (Engerix, 3 doses) - $58.00  
  • Hepatitis B (Heplisav-B, 2 doses) - $130.00
  • HPV (Gardasil 9) - $290.00
  • Japanese Encephalitis - $399.00  
  • Measles/Mumps/Rubella (MMR) - $101.00  
  • Meningococcal (Bexsero) - $183.00 
  • Meningococcal (Menactra) - $147.00 
  • Pneumonia (Pneumococcal) - $134.00  
  • Polio (Poliovax) - $41.00 
  • PPD (Tuberculosis) - $20.00   
  • Rabies (Rabies) - $395.00  
  • Tetanus Diphtheria (Tetanus Diphtheria) - $38.00
  • Tetanus Diphtheria & Pertussis (Tetanus Diphtheria & Pertussis) - $46.00  
  • Typhoid (Typhim) - $128.00  
  • Yellow Fever is currently unavailable

Immunization fees are per dose and some require more than one dose. 

Please visit the CDC website for more information on the national Yellow Fever vaccine shortage.

Birth Control

  • IUD (Paragard) - $1,055.00
  • IUD (Mirena) - $1,231.00
  • IUD (Kyleena) - $1,230.00
  • IUD (Skyla) - $1,024.00
  • IUD (Insertion Only) - $508.00
    • IUD purchased through prescription plan
  • Etonogestrel Implant (Nexplanon) - $1,335.00
  • Diaphragm - $92.00

Miscellaneous Services

  • Cane Deposit - $22.00  ($17.00 will be credited when item returned)
  • Crutch Deposit - $29.00  ($24.00 will be credited when item returned)
  • Copy Of Medical Record - $15.00 per copy
  • Copy Of X-Ray - $12.00 per copy

Form Completions

  • Signature only - $0
  • Moderate complexity - $20.00 per form
  • Complex - $50.00 per form

Inpatient Admissions

Most admissions to the Inpatient Nursing Department are at no cost to the student.  This would include medical, post-surgical and mental health concerns.

Billable admissions would include:

  • Admissions for intoxication - $464.00
  • Admissions requiring IV fluids for the first 24 hours - $464.00 
  • Admissions requiring IV fluids after the first 24 hours - $1,153.00 per day

Please Be Aware: 

  • Patients will be responsible for lab, x-ray, IV fluids and medication fees associated with an inpatient admission.
  • Billable admissions can be submitted to your insurance for reimbursement.  The Dartmouth Student Group Health Plan (DSGHP) reimburses 100%.

 

Labs / Testing

Any lab that is not paid for by the Dartmouth College Health Service (Dick's House) will be billed directly to the patient by the Dartmouth-Hitchcock Medical Center who processes the specimens.

 

Making a Payment

All billable service fees will automatically be posted to the student's tuition account if not paid for at the time of service with cash, check or credit card.  Charges posted to a student's tuition account do not state the service or treatment provided as that information is confidential and cannot be released without the patient's written consent. 

We are unable to submit claims to insurance companies; however, upon written request of the patient, an invoice will be provided which may be submitted to his/her health plan for reimbursement -- please send a request to Patient Accounts.

Insurance Reimbursement

If you are a member of the Dartmouth Student Group Health Plan (DSGHP), most of the billable services will be submitted to the Plan directly for you through a secure portal by the Patient Accounts Office.  A few weeks later the DSGHP Office here on campus will post a "DSGHP Reimbursement" payment to your student tuition account where the charge was posted.  DSGHP reimburses 100% of the following charges when received at the College Health Service:

  • Leave term office visits
  • Athletic Physicals
  • DOT Physicals
  • Immunizations
  • Birth Control Devices
  • Rapid Flu Tests
  • Inpatient Admissions

 The DSGHP does not cover or reimburse the following charges at the Health Service:

  • Form Completions
  • Cane or Crutch Fees
  • X-ray Copy Fees
  • Medical Record Copy Fees 

 

If you have waived enrollment into the DSGHP, keeping your own health plan, the Health Service will be an out of network provider and unable to submit claims directly to your health plan on your behalf.  However, the Patient Accounts Office can, at the patient's request, provide an invoice that the patient may submit to their health plan for possible reimbursement.  The amount of the reimbursement, if any, will be determined by your plans terms and conditions.  If you have an outside plan and need a billable service, stop by or call the Patient Accounts Office to go over the billing prior to receiving the service.