As the Patient Protection and Affordable Care Act has created an opportunity to obtain 100 percent insurance reimbursement for preventive care services, some college health and counseling services have rushed to take advantage of insurance billing revenue opportunities without carefully considering the regulatory requirements. This paper addresses the concern that such services may inadvertently engage in impermissible billing practices and explains how to obtain secondary payor status for health fees and other institutional funding arrangements in the coordination of benefits process with students’ personal health insurance.