The ColoHealth Health & Wealth Newsletter
June 2023
Vol. 13, Issue 7

How To Explain Healthsharing To Your Doctor

As healthsharing becomes more and more popular across the country, most doctors are catching on to how these health sharing ministries work and how to work with patients who are medical cost-sharing program members.

But there are still many doctors out there who have not encountered health sharing plans before, and need some help from patients in educating them on how they work.

After all, they have been used to working with traditional insurance reimbursement procedures for many years, and some have not trained their staff on healthsharing plans.

In this newsletter, we’ll talk about the most common issues that arise with physicians and office staff who are new to healthsharing, how to minimize confusion, and make the process work as smoothly as possible, for everyone.

So you can get your medical bills shared by your fellow healthsharing members, with a minimum of hassle.

Why Healthsharing?

In recent years, Health Share programs have gained increasing popularity as cost-effective alternatives to traditional health insurance plans, offering significant potential savings for both individuals and families compared to unsubsidized ACA-style health insurance policies.

Many healthsharing organizations, though not all, are religious in nature. Many health share members enjoy the fact that they can share their plan with like-minded, health conscious individuals who share their values.

Explain to your doctor how healthsharing provides a direct benefit to their patients by making protection against the high cost of unexpected medical bills more affordable – up to 50% more affordable in many cases.

Educate your Doctor about Healthsharing

Don’t assume all doctors are familiar with the health sharing concept. Take the initiative to explain to your doctor what a healthsharing plan is and how it differs from traditional health insurance.

Emphasize that these plans are really a mutual aid society: a community of like-minded individuals who agree to help support one another in covering medical expenses.

Providing this information helps your doctor understand the unique aspects of your healthcare plan.

Since healthsharing plans are not insurance, many providers may provide you with a cash payer discount. Ask for the best rate possible for cash-pay or self-pay patients.

Under recent healthcare price transparency legislation, hospitals and clinics are required by law to disclose their prices and cash pay discounts up front on their websites.

Healthsharing Terms

For legal reasons, healthsharing organizations must use different terminology than insurance companies, even though these terms may refer to similar concepts.

If your doctor’s office is new to healthsharing, you may have to guide them through some common terms. For example:

In insurance, you have a deductible. In healthsharing you have a member portion, annual household portion, or member responsibility amount.
In insurance, you file a claim. In healthsharing, you submit a cost sharing request.
Insurance policies provide coverage; healthsharing plans share costs.
In health insurance, you have a policy. In healthsharing, you have membership guidelines.

Healthshare Billing and Reimbursement Procedures

Both you and your doctor need to understand how to submit cost sharing requests to your healthshare ministry organization.

Every healthshare plan has a slightly different procedure. But nearly all of them will require detailed documentation of the medical issue and the treatment provided.

Providers will need to provide itemized invoices for all services rendered. The more detailed and thorough the documents your doctor provides up front, the sooner the healthshare organization can disburse any reimbursement or sharing assistance due the doctor or the patient.

Show your doctor or their billing staff your membership card, and point out the website and contact information on it that they can use to resolve questions about how to submit sharing requests.

Discuss Prescription Medications Early On.

Many healthsharing plans do not include a traditional prescription drug insurance component. But most provide members with an excellent discount plan.

However, it is often especially important for healthsharing members to use generics where available, rather than higher-priced brand-name drugs.

If you require prescription medications, ensure your doctor understands your Healthshare plan’s policies regarding medication coverage and reimbursement.

Discuss potential alternatives or cost-saving measures if certain medications are not included in your discount plan.

Help Your Doctor Out

Occasionally, your health share plan may ask you or your doctor for additional information.
Be proactive in responding to these requests, whether from your doctor or from your healthshare plan.

The sooner you respond, the sooner you will get your eligible medical expenses shared. .

Offer accurate information, provide necessary paperwork, and share contact details for your halthsharing ministry organization.

If any confusion arises, offer to communicate directly with your healthsharing plan to resolve any billing concerns promptly.

Being proactive and helpful demonstrates your commitment to working collaboratively with your doctor. It will also make the process much easier for the next healthsharing patient who comes along.

Be Calm and Patient

Keep in mind that your doctor may be unfamiliar with health sharing in general, leading to concerns or confusion. Approach conversations with patience, understanding, and a willingness to provide information and support.

Even if your doctor is initially confused about health sharing, prove yourself to be a responsible and reliable patient, working towards building a relationship of mutual trust.

Patience and cooperation will go a long way in creating a positive environment for effective communication.

Developing a strong doctor-patient relationship based on trust and understanding is key to navigating HealthShare billing successfully. Consider the following approaches:

Keep good records

Keep copies of all relevant documentation, including itemized bills, receipts, and correspondence with your healthsharing plan.

Make a digital or physical folder dedicated to keeping records of everything having to do with your medical treatment.

Having organized records will make it easier to track and submit share requests when necessary, and can help facilitate payments to your doctor and reimbursements to you.

Know Your Plan’s Exclusions and Limitations

Understand that certain services or treatments may not be eligible for sharing.

Familiarize yourself with any exclusions and limitations to avoid surprises and proactively explore alternative options for coverage. Don’t blame your doctor for these exclusions.

Conclusion

If your doctor is not already familiar with healthsharing, working with them may require more effective communication, patience, and cooperation.

While not all doctors or medical office managers are completely familiar with healthsharing, normally all you need to do is explain the concept briefly. If they have any questions, tell them they can call the number on your membership card for more information.

The result will be a beneficial relationship for you and your doctor alike.

To Your Health and Wealth,

signature-wiley

Wiley P. Long III
President- ColoHealth

The ColoHealth Health & Wealth Newsletter is published monthly and emailed to subscribers at no charge. Subscribe now to stay on top of the critical information you need to know about health insurance, healthshare plans and managing your finances to achieve financial security.