Going to the Doctor

STEPS TO CARE

ShareRight, a program of Impact Health Sharing, is not a new concept, but it is a new blend of a lot of the things that work RIGHT in healthcare. And, getting the care you need is easy with a few simple steps.

1: CHOOSE A PROVIDER

ShareRight supports your choice to see any provider you choose.

If you would like help locating a provider, contact ShareRight and ask to speak with a Care Navigator.
2: SHOW YOUR MEMBER CARD
At every appointment, show your member card. If the provider isn't familiar with Impact or asks you to self-pay, don't worry. Both situations occur, and neither prevents using your membership or seeing your chosen provider.
3: PAY YOUR PROVIDER FEE

You'll have a small provider fee to pay at each visit. This fee is part of your agreement with ShareRight and is not part of the costs that are shared.

The provider fee is $0 for Urgent Telemedicine, $50 for each primary care visit, $75 per specialist or urgent care visit or $150 for an emergency room visit or hospitalization.
STEPS TO SHARING

When you get medical care with ShareRight, your doctor may bill ShareRight directly or ask you to self-pay.
Whether you submit your bills for sharing directly to ShareRight or your provider submits them to us, you are still saving with ShareRight and seeing the provider you choose.
OPTION A:

DIRECT ELECTRONIC BILLING

Some doctors bill ShareRight directly. They handle the billing, and ShareRight coordinates the healthcare costs with them. Your bills must be eligible for sharing, and your PRA must be met before any costs can be shared. The exception here is your annual physical and a $150 lab allowance, which are shared fully, even if you haven't met your PRA.
OPTION B:

SELF-PAY

If your healthcare provider requests payment in advance, proceed with the payment and then submit your receipt and bill to ShareRight in the Member Center. When you pay cash, ensure you obtain a HCFA, UB, or at the very least, an itemized bill. Don't forget to ask for a 'cash pay' discount or 'self-pay' discount, as these can significantly reduce your out-of-pocket expenses.

Eligible medical bills will either be applied towards your Personal Responsibility Amount (PRA) and co-share or, if your PRA has already been met, they will be published for sharing and subsequently reimbursed.

If these costs are from your annual physical or $150 lab allowance, you will be reimbursed once the bill is processed. No need to meet your PRA first.
In the end, whether your doctor bills ShareRight directly or you pay first, your medical needs can be shared through ShareRight, as long as your costs are eligible for sharing and your PRA is met. Both methods are just different ways to handle payment.

Bill Processing

WHAT CAN I EXPECT?

ShareRight’s electronic bill processing, digital sharing, and distributed medical reserves enables payment to providers, typically 30-40 days after receipt of the members’ bills. This approach sets ShareRight apart from the healthcare sharing process that many providers may have experienced with other healthcare sharing organizations. It is our aim to provide an experience that works better, feels better than insurance for our members.

If your provider is asking for more information, just ask them to give us a call.

We find that it is most efficient for medical providers to submit bills for their services electronically through EDI and to the Payor ID on the back of the member’s card.
This allows ShareRight to process and adjudicate medical bills for eligibility per the Program Guidelines quickly. Most bills are processed in less than 30 days.
Once processed, ShareRight members share funds from their Share Accounts to pay each other’s medical bills; on average in 3-4 days.

At this point, ShareRight remits payment electronically to providers, less any Member Responsibility Amounts (i.e., Deductibles, Co-Pays, or Co-Shares) and furnishes the provider with an EOP (Explanation of Payment) detailing the amount(s) paid.

PRE-ELIGIBILITY

Providers are required to apply for pre-eligibility for any of the following treatments to be eligible for sharing:

Cancer Treatment
Elective Cardiac Procedures
Non-emergency inpatient/outpatient surgery
Organ/Tissue Transplant Services
Maternity
Imaging: MRIs and Nuclear Imaging (i.e. PET scans)

Providers may apply for pre-eligibility by calling (855) 610-2805.

3-5 business day notice required, expedited review on a case-by-case basis.

Medical records are required to determine pre-eligibility and failure to provide requested records for review will result in the bill being ineligible for sharing.