Balance Bills: Protect Yourself Against Unexpected Medical Bills
Our healthsharing members are committed to stewarding not only their health, but also the health of their sharing community. Members do this through voluntary giving, committed participation in the healthsharing process and active management of their shared resources.
As a self-pay patient who negotiates fair prices for medical services, it’s essential that you take the proper actions before receiving care. Communicating with your provider, receiving a discount for services and planning how to handle your medical expenses while you wait for community sharing can reduce the possibility of your provider balance billing you.
However, if you receive a balance bill from your provider, you need to know what a balance bill is and how to handle them.
Balance bills are medical charges that exceed a fair and reasonable amount for a medical service. As self-pay patients, healthsharing members agree to share discounted, fairly-priced medical expenses. After an eligible medical expense has been submitted to your sharing community, it is either applied to your Annual Unshared Amount (AUA) or it is shared by other members. After receiving payment some providers send a request for the remaining balance of the expense.
As a self-pay patient, be sure to follow these steps when you have a medical need:
• Discuss healthsharing with your provider.
• Request fairly-priced, self-pay discounts.
• Manage your healthcare expenses and make small payment arrangements with your provider if necessary.
How will you know if you have been balanced billed?
If you have been balanced billed by a provider or hospital, you will receive a bill requesting an additional amount for a medical expense after the fair and reasonable portion of an eligible expense was previously shared by members.
While balance bills are not eligible for sharing, Liberty HealthShare provides a service through Self-Pay Advocates, to assist members with balance bills. Self-Pay Advocates’ goal is to arrive at reasonable pricing that is affordable for the member and the provider.
Upon receipt of a balance bill, Liberty HealthShare members should email a copy of the bill as soon as possible to email@example.com.
Once received, Self-Pay Advocates will send a follow-up email to the member that will include the following:
• Name and contact information of the member’s dedicated advocate.
• HIPAA Release & Authorization Form to speak to the provider on the member’s behalf.
• Fair Credit Reporting Act Letter that will be sent to the provider to suspend the bill from going to collections.
• Appointed Representative Form allowing self-pay advocates to be the member’s representative.
• A “Know-Your-Rights” Document equipping members to answer collection calls and letters, should they occur.
Members will then be asked to schedule an initial 15-minute call with their dedicated advocate.
While balance bills with a service date prior to May 1, 2022 remain eligible for sharing, Liberty HealthShare members may utilize Self-Pay Advocates for these bills as well.
It is every member’s responsibility to ask for a fair price for medical services, as it is essential to remember as we are a community-focused, healthsharing ministry.