At Solidarity, we hear our Members facing barriers that shouldn’t exist in healthcare. More often than not, patients feel powerless in the face of confusing billing practices, disorganized hospital systems, and demands for upfront payment. Many assume they just need to go along with whatever a hospital says, even when it doesn’t feel right. That’s exactly why Solidarity exists: to step in, to fight for fairness, and to protect our Members, when they combat injustice in the insurance medical complex.
What Is a Single Case Agreement?
One of the tools we use to help our Members is a Single Case Agreement (SCA). An SCA is an agreement negotiated between Solidarity and a healthcare provider or hospital system. It states in writing that a Member will receive care at a set, discounted rate for all services, supplies, and follow-up care related to a specific treatment period. SCAs ensure clarity and fairness for both patients and providers and protect Members from unpredictable charges.
The Situation: A Family in Crisis
In February 2025 just this year, we finalized a Single Case Agreement with a large children’s hospital, covering all services for one of our Members from 2/10/25 through 12/31/25. This agreement was signed not only by Solidarity, but also by the hospital’s Vice President of Payor Relations. Yet, months later, we heard from the Member’s mother: the hospital refused to perform her child’s MRI without an upfront payment of $3,934.56, forcing her to put the charge on her personal credit card.
Not only did this violate the terms of the SCA, but the charge itself didn’t even align with the hospital’s own MRI charge rates or our agreed upon reimbursement. It was a moment of confusion, frustration, and financial stress for a family already focused on their child’s health.
That’s when Solidarity stepped in.
How We Fought for the Member
Our Member Experience Team immediately contacted the hospital’s billing department to set the record straight. At an initial review,, the hospital representatives couldn’t even find the Single Case Agreement in the Member’s file.
This is a reality we see far too often; even large, well-known hospital systems can be so disorganized that the “the left hand doesn’t know what the right hand is doing.” We provided the hospital with the fully executed SCA, ensuring that the agreement, already signed by their own leadership, was recognized and enforced.
After escalating the issue, the hospital’s payor relations vice president confirmed the error, approved a full refund, and directed their team to bill Solidarity directly under the agreed-upon discounted terms. By the next day, the family had confirmation that they would be fully refunded and protected from future confusion.
The Bigger Picture
This story is not unique. Across the country, patients are often told to pay upfront when they don’t have to, billed for amounts inconsistent with agreements, or caught in the middle of hospital miscommunication. Disorganization at the hospital level is not just an inconvenience, it’s a driver of medical debt, anxiety, and delayed care. A 2022 Kaiser Family Foundation report found that 41% of U.S. adults carry medical or dental debt, and nearly 1 in 4 bills are sent to collections often the result of errors or breakdowns in hospital billing systems.
Why Members Must Speak Up
If something doesn’t seem right, it probably isn’t. Members should never assume a demand for upfront payment, a confusing bill, or a denial of service is legitimate. Most of the time, there is an error, a breakdown in communication, or a misapplication of policy.
That’s why Solidarity exists. We don’t just share in the cost of care. We have Care Coordination and Care Navigation teams that advocate, negotiate, and correct these errors on behalf of our Members.
A Clear Message
This family’s story is a reminder of two important truths:
- Hospitals’ financial practices, no matter how large, are often disorganized and inconsistent.
- Members should always contact Solidarity when something doesn’t seem right.
Because when they do, we can step in, enforce agreements, and protect families from unnecessary financial hardship. At Solidarity, we believe that healthcare should heal, not harm; support, not stress. And we will continue going to bat for our Members. If you’d like to learn how a Solidarity membership could help you and your family, give us a call today at 737-SHARING.
