At some point in your membership with Liberty HealthShare, you might find yourself dealing with what is known as a balance bill. In short, balance billing is what happens when a bill has already been paid and the physician or provider attempts to get more money directly from their patient. It's important to note that balance bills represent only a fraction of the costs that are submitted to Liberty, however, we want to give you the information and steps you will need to properly respond if you find yourself in this situation.
Ideally, here is how things ought to go. As a member of Liberty HealthShare, you are considered a self-pay patient in the eyes of the healthcare industry. When you go to your doctor or another provider, you should let them know this information up-front. If the provider’s office accepts your card, they should submit your medical bills directly to Liberty for processing. This works well because, in many cases, we are able to successfully adjust member costs, often by significant percentages. Not only does this reduce the financial burden on our members as they share in one another's costs, but it also helps restore financial accountability to the healthcare industry.
If your provider is unwilling to accept your card, don’t be afraid to ask what kind of discount they are prepared to give a self-pay patient. Then you can assess whether you are able to pay this cost out of pocket and later submit the cost to Liberty for sharing (provided it is eligible). Don't hesitate to contact member services at (855) 585-4237 if you have any questions during this process. If the discount offered seems small or if this kind of arrangement is too financially burdensome for you, we recommend you look for a provider who is willing to work directly with Liberty in the future. Here's a little behind-the-scenes look at how we work with providers:
Liberty's payment schedule has been shown over time to be simple and fair. Physicians are familiar with Medicare. We simply start with the Medicare reimbursement schedule and then add between 50% and 70% more to that amount, depending upon the services rendered. Even if a provider does not agree to this reasonable amount, our representatives are often able to negotiate a rate on which everyone can agree. Once a provider agrees to a payment schedule, eligible bills are submitted either for sharing within our community or to be paid directly by the member as part of their annual unshared amount (AUA).
It clearly states on the reverse side of every Liberty HealthShare membership card that once a provider accepts payment from LHS on behalf of a member, they cannot seek further payment from the member. If they do, that's a balance bill. For a provider to agree to our payment schedule and then come back to the patient for more money isn't just a hassle. We believe it is wrong.
We know that medical costs can be overwhelming at any time, and we want to do everything we can to engender peace of mind in our members. That's why, if you are balance billed, the first thing we want you to do is to contact us by calling us at (855) 585-4237. We will help you determine whether you have in fact been balance billed, and then we'll take over the work of setting things straight with your providers.
Unfortunately, balance billing has become a practice in which many providers engage. It’s intimidating, and members may end up paying those bills without knowing they are not required to pay. We urge you to communicate with us about any billing you receive. We are here for you and are ready to support you.
To learn more, watch this short video: