How Repricing Works

The Purpose of Repricing Medical Bills

Liberty HealthShare takes a multitude of steps to ensure that members are getting the most out of taking control of their healthcare in a supportive, like-minded community. One way is through empowering our members by utilizing the services of HST and providing optional access to the PHCS Network to reprice eligible medical expenses to fair and reasonable amounts, thereby saving our sharing community significant amounts of money!

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Fair & Reasonable

All eligible medical expenses go through a repricing process to ensure that the amount being shared by the Liberty HealthShare community is “fair and reasonable.” A full explanation of what is fair and reasonable is available in the Sharing Guidelines, but in short this repricing takes into contracted rates, typical local costs, available discounts, and Medicare-based benchmarks for such services. For inpatient or outpatient facility eligible medical expenses the fair and reasonable amount is generally equivalent to 140% of the Medicare equivalent allowable amount. For physician and ancillary eligible medical expenses the fair and reasonable amount is generally equivalent to 120% of the Medicare equivalent allowable amount.

Repricing Process

To make this repricing as smooth and effective as possible for members, Liberty HealthShare utilizes the repricing vendor HST, along with their powerful tool HST Connect, to protect and strengthen member Sharepower. HST Connect allows members to locate a provider near them who participates in the PHCS Network, because PHCS Network participating providers are more likely to accept fair and reasonable pricing. This network helps our members reduce their likelihood of receiving a balance bill, which is the difference between a provider’s total billed charges less any portion of the medical need applied to a member’s Annual Unshared Amount and any amount shared by other members.

Supporting A Strong Community

So why go through all of this to reprice eligible medical expenses to the fair and reasonable amount? For one thing, it helps ensure that our community is not sharing unreasonably priced medical costs. Sharing eligible expenses at fair and reasonable amounts helps to keep members’ monthly share contributions low. Additionally, this policy of medical bill repricing helps empower our members to be more proactive and selective in the medical care they receive. Liberty HealthShare members become more informed and responsible healthcare consumers, which in turn makes our community stronger! In 2024, fair and reasonable pricing saved our members more than $300,000,000!

Medical bill repricing keeps our community strong, our members informed, and your healthcare your choice! Take the first steps today in your journey on the path where faith and healthcare unite with Liberty HealthShare!