Law of Large Numbers in Medical Cost Sharing

Law-Of-Large-Numbers.jpgOne medical incident can cost thousands of dollars, which doesn't fit into the typical household's budget. However, rather than trying to pay bills alone, individuals can come together to take advantage of the law of large numbers, a mathematical principle that has significant implications for healthcare.

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What To Do If You Ever Need Surgery

An exciting resource now available to Liberty HealthShare Members

In the town of Hutchison, Kansas there is a little known, but exciting secret. And it's not just in Hutchinson. It may be in your town too. It is a place you may pass by everyday, but not realize what it could be doing for you. What is it? A Surgery Center. 

Surgery Centers are medical facilities that provide outpatient surgeries and short-stay procedures. In fact, most outpatient procedures can be performed in local Surgery Centers. According to Bud Brooks,Vice President and Co-founder of Surgery Center Network, typical procedures include Orthopedic, ENT, OBGYN, Urology, and even minor spine surgery. Because these procedures are performed repeatedly they are systematic and very efficient.

Brooks states that Surgery Centers are typically 5 to 20 times less expensive than the same procedure performed in a hospital setting. This is mainly because hospitals have more overhead than Surgery Centers since hospital facilities and staffs are larger. The lower overhead of surgery centers helps to keep costs down, as their financial means are utilized more efficiently on outpatient procedures.
 
Bud Brooks also informed us that most surgeons that have privileges at hospitals, also have privileges at private Surgery Centers. So this means you can have the same doctor for the same procedure, at a better price!

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Don't Be A Victim Of 'Balanced Billing'

What Liberty HealthShare members should do in this predicament. 

The Liberty HealthShare payment schedule to medical providers has been shown to be a simple and fair system. However, even after accepting payment for service, some medical providers engage in what is called balanced billing.

Frankly speaking, balanced billing occurs when a doctor or hospital tries to get extra money directly from a patient, after a bill has been paid. This practice isn’t fair, and there is no reason for a patient to pay it.

Liberty Healthshare has a payment schedule that every provider in the nation is familiar with. We take the cost of any procedure that is laid out in Medicare, and pay an additional fee. We call it Medicare Plus Bonus!
 
The provider reimbursement terms are clearly explained on the back of every Liberty HealthShare membership card. Payments range from 150% of Medicare for Physicians, to 170% of Medicare for out patient services. We find that 90% of doctors and hospitals approve without question. If there is an issue with that payment schedule, we simply negotiate a different one.  
 
Once a provider agrees to the payment schedule, bills are then submitted and paid through our community or directly from the member if that payment applies to their annual unshared amount, from $500 to $1,500 based upon household size.
 
So, what do Liberty Healthshare members do if they are balanced billed?
 
First, if you receive a bill from your provider in the mail, check your online Sharebox at LibertyHealthshare.org. In the Medical Expenses section, you will be able to see any expenses that we have received on your behalf. The bill that you received might be an expense that goes toward your Annual Unshared Amount. It will be reflected in your online account, and will show up under AUA. This is a case where you are being billed correctly, and you will need to pay your provider directly.
 
However, if it is a bill that is not reflected in your Sharebox, then Liberty Healthshare has not received that bill, and this might be balanced billing. Contact member services immediately. We can get this issue resolved. Contact us by calling 855-585-4237.
 
From there, we will discuss your bill and ensure that it is either an eligible sharing expense, a bill that is in process, or that it might be a balanced bill. If it is a balanced bill, then we will turn it over to our provider relations department.

Provider relations will take that bill back to the provider, and let them know that they have been paid. If they do not agree with the reimbursement schedule, then we will negotiate a different payment with them.

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Update on Credit Card Transactions

Making Liberty HealthShare cost sharing better and more efficient.

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