Solidarity Blog

Does Solidarity Have a Timely Filing Limit?

What is a Timely Filing Limit?

Timely filing limits are standard practice in the healthcare industry, whether you’re on health insurance or with a healthshare. Basically, when a provider delays sending a medical expense beyond a reasonable timeframe, the bill is not eligible for sharing. At Solidarity, we have set our timely filing limit to be 90 days. So, when a provider fails to send the itemized bill for a procedure they provided to one of our Members to us within that timeframe, we are not able to share into the medical expense. In that case, your provider is responsible to write off the expense. It was their failure to submit the bill in a timely fashion that caused a financial burden for the Member.

Why did Solidarity Institute this Policy?

Forecasting Medical Needs

Our Members’ Monthly Contribution Amounts are based on the expected medical needs of our community. We did not have a timely filing limit for the first few years of our operations. However, when we did an analysis of the timeliness of our received bills over a three year period, we saw that only 54% of the bills that we received had arrived within 90 days of the date of service. Over $20 million in billed charges had been received over a year after the service took place. These delays made it impossible to fully anticipate the community’s medical needs within a given timeframe. This can be a precarious position for a healthshare to be in, because it means that the community is now in a position where they need to catch up to meet the financial needs of the community, instead of being ahead of them.

In order to be good stewards of the sharing funds that our Members contribute to their community each and every month, it became clear that we needed to hold providers accountable to submit their bills on time. So, we instituted a standard timely filing limit. It allows providers and Members a reasonable amount of time to submit a medical need, without allowing old bills. This ensures the financial stability of the organization, and so the proliferation of our ministry.

What if a Bill is Past the Limit?

If you feel that one of your medical needs should be shared because it was not reasonable to submit in a timely manner, you should contact our Member Care team and ask about appealing. When a provider agreed to bill Solidarity directly, and failed to do so in a timely fashion, the first step will be to request that the provider write off the expense. Many providers will do so when they realize their mistake caused this situation, as it is their responsibility to do so. We must hold providers to a standard of practice that protects our Members. However, if the provider refuses to write off the bill, you should still reach out to our team and we may be able to help.

If there is a different reason why it was not reasonable to submit the bill in a timely manner, let our team know, and they will be able to guide you through the appeals process to see if any changes can be made.

When did Solidarity Institute a Timely Filing Limit?

When we launched the Solidarity ONE program in November of 2021, we also updated our Sharing Guidelines. This included some new services that would be eligible, such as expanded prescription sharing and unlimited mental health counseling. It also included our 90 day timely filing limit. Timely filing can be a difficult topic to talk about, and for many it’s tough to see why it’s necessary. But at Solidarity, we do more than simply reimburse Members for their medical expenses. We have set out to provide a viable alternative to health insurance, which means we need to be able to hold providers accountable to an ethical standard practice, and we need to be able to ensure that our organization has the financial stability required to be available for generations to come.