Solidarity offers many great features and services that countless families and individuals have been searching for ever since the Affordable Care Act went into effect almost a decade ago, but may not know about.
For example, with Healthcare Sharing Ministries Members enjoy: healthcare that does not support immoral medical procedures, control over their healthcare decisions, and a way to fight back against the runaway costs of the medical industry.
Solidarity addresses all of this – and much more – for our Members by providing ethical, affordable, and flexible options to get quality, comprehensive healthcare for you and your family.
With the many significant upsides that healthcare sharing offers, there can be a learning curve when you switch to a totally new approach to funding your healthcare. Solidarity HealthShare facilitates the voluntary sharing of money among its Members to pay for eligible medical expenses. We do not have any network of providers, so you can go to any provider, and they can send your medical expenses to us directly to be shared among the other Members.
Here are some tips for how to make the best use of your Solidarity HealthShare Membership:
Direct Provider Billing
Although paying for your medical expenses up front and submitting them for sharing (reimbursement) is an option, it can make the billing process longer, more complicated, and more expensive. We recommend having your provider bill us directly whenever possible.
Member Submitted Bills
When a Member pays their bill as a self-pay patient and submits it for reimbursement, there are a few added steps. First, you need to make sure that you get an itemized bill for your service, which includes the procedure (CPT) code and diagnosis (ICD-10) code for each item, along with some other critical information (see the full list here). If the bill that the provider gives you doesn’t include all of that information, make sure to ask them to send you an amended bill which does. Once all of this information is received, it is then entered manually and validated to make sure that all the information we need is there. If the submitted bill is missing some of the necessary information, that will delay the processing for that bill until all the information is received.
Provider Submitted Bills
When a provider submits a bill to us directly, all of the necessary information is already included on the forms that they fill out and submit. This speeds our processing time considerably, as that information can be entered into our system automatically, and gets processed without needing to be reviewed on a manual basis. We are also able to negotiate pricing with providers when they bill directly, and average saving about 60% off billed charges. We work very hard to maximize the sharing power of our community so that we can share all of the medical expenses that our Members need. This is why it is so important to advocate for your provider to bill Solidarity directly. For some helpful walkthroughs on how to talk to providers about direct billing at the time of service, Click Here.
We also have a dedicated Care Navigation team that can help you find Preferred Providers in your area. This is the best option, as these providers have already agreed to bill us directly on your behalf, and to charge reasonable rates for their services. If there are not Preferred Providers that meet your needs near you, our Care Navigation team can still help find providers that are willing to bill directly and are friendly with our Reference Based Pricing model.
When you find out you are pregnant, have your provider complete a Pre-Notification for your Maternity care as early as possible. This allows us to start negotiating with your providers and processing your Maternity bills in advance. Once that Pre-Notification is approved, our Maternity Advocate will contact you to support you through the whole process.
As part of your Membership, you are automatically enrolled in our telehealth service, administered through DialCare. This service is an excellent resource for our Members to get quality, cost-effective care for common medical ailments, rather than going to the doctor’s office.
DialCare Physician Access connects you with doctors who are licensed to practice in your state, via phone and video chat, to provide treatment and advice, including writing prescriptions when appropriate. They are available 24/7, 365 days a year. Best of all, these virtual consultations are included with your Membership, so there is no charge at the time of service.
We also share into telehealth visits with your physician, as long as you have had at least one in person visit with that doctor before. This offers important flexibility to get the care you need with your preferred physician, even when they are not available in person. This has become especially important given the sharp increase in telemedicine with the Covid-19 pandemic.
Solidarity is the first healthshare to offer comprehensive sharing for generic prescription medications through our Solidarity ONE program. For Solidarity ONE Members, generic prescriptions are a fully shareable expense, even for maintenance medications and pre-existing conditions. Generic prescription drugs are eligible for Sharing and are not subject to the Annual Unshared Amount. Members have access to Drexi Pharmacy Sharing for retail prescription drugs based on the current formulary and co-share schedule. Click Here to learn more about how to activate your Drexi account, search for prescription discounts near you, and start using this great program.
Balance Bill Advocacy
Balance bills occur when a provider decides to bill the Member for the excess amount after a medical bill has been repriced to the fair and reasonable amount. We work to minimize this as much as possible, and less than 5% of our Members’ medical needs end up getting balance billed. Of those, 96% of providers cease any balance billing once the Member’s responsibility for their Annual Unshared Amount has been paid in full.
In the unlikely event that you receive a balance bill, we work to defend you from paying unnecessary charges, while ensuring that the provider is paid fairly. We reach out to the provider to dispute the excessive charges. As long as the bill is being disputed, providers are prohibited from reporting your bill to Credit Reporting Agencies. The critical thing to remember when you receive a balance bill is to send everything that you receive from the provider regarding that balance bill to our Patient Advocacy team as soon as possible, so that we can dispute the charge on your behalf. For more information about what to do when you receive a balance bill Click Here.
If you have more questions, we recommend checking out our Knowledge Center. This Member resource is available to help with all sorts of common questions 24/7. Just type in a question or a term (i.e. “wellness visits”) and choose from the available answers. Visit the Knowledge Center here.