Going to the Doctor
STEPS TO CARE
Impact Health Sharing is not a new concept, but it is a new blend of a lot of the things that work RIGHT in healthcare. And, getting the care you need is easy with a few simple steps.
1: CHOOSE A PROVIDER
Impact supports your choice to see any provider you choose.
If you would like help locating a provider, contact Impact Health Sharing and ask to speak with a Care Navigator.
2: SHOW YOUR MEMBER CARDAt every appointment, show your member card with Impact's billing information. If the provider isn't familiar with Impact or asks you to self-pay, don't worry. Both situations occur, and neither prevents using your Impact membership or seeing your chosen provider.
3: PAY YOUR PROVIDER FEE
You'll have a small provider fee to pay at each visit. This fee is part of your agreement with Impact and is not part of the costs that are shared.
The provider fee is $0 for Telemedicine, $50 for each primary care visit, $75 per specialist or urgent care visit or $150 for an emergency room visit or hospitalization.
DIRECT ELECTRONIC BILLING
Some doctors bill Impact directly. They handle the billing, and Impact coordinates the healthcare costs with them. Your bills must be eligible for sharing, and your PRA must be met before any costs can be shared. The exception here is your annual physical and a $150 lab allowance, which are shared fully, even if you haven't met your PRA.
If your healthcare provider requests payment in advance, proceed with the payment and then submit your receipt and bill to Impact using the Medical Expense Form. When you pay cash, ensure you obtain a HCFA, UB, or at the very least, an itemized bill. Don't forget to ask for a 'cash pay' discount or 'self-pay' discount, as these can significantly reduce your out-of-pocket expenses.
Eligible medical bills will either be applied towards your Personal Responsibility Amount (PRA) and co-share or, if your PRA has already been met, they will be published for sharing and subsequently reimbursed.
If these costs are from your annual physical or $150 lab allowance, you will be reimbursed once the bill is processed. No need to meet your PRA first.
In the end, whether your doctor bills Impact directly or you pay first, your medical needs can be shared through Impact Health Sharing, as long as your costs are eligible for sharing and your PRA is met. Both methods are just different ways to handle payment.
Provider Outreach Request
If your provider is unsure or unwilling to accept Impact, please fill out the form below and we will reach out to them.
To ensure that our team can contact your provider, please make sure you have a scheduled appointment that is at least 72 hours after the submission of this form. If your need is urgent, please contact 855-378-6777.
WHAT CAN I EXPECT?
Impact Health Sharing’s electronic bill processing, digital sharing, and distributed medical reserves enables payment to providers, typically 30-40 days after receipt of the members’ bills. This approach sets Impact Health Sharing apart from the healthcare sharing process that many providers may have experienced with other healthcare sharing organizations. It is our aim to provide an experience that works better, feels better than insurance for our members.
If your provider is asking for more information, here are some instructions you can provide. Or, just ask them to give us a call.
- We find that it is most efficient for medical providers to submit bills for their services electronically through EDI and to the Payor ID on the back of the member’s card.
- This allows Impact Health Sharing to process and adjudicate medical bills for eligibility per the Program Guidelines quickly. Most bills are processed in less than 30 days.
- Once processed, Impact Health Sharing members share funds from their Share Accounts to pay each other’s medical bills; on average in 3-4 days.
- At this point, Impact Health Sharing remits payment electronically to providers, less any Member Responsibility Amounts (i.e., Deductibles, Co-Pays, or Co-Shares) and furnishes the provider with an EOP (Explanation of Payment) detailing the amount(s) paid.
Members or Providers are required to pre-notify Impact for any of the following treatments to be eligible for sharing:
- Cancer Treatment
- Elective Cardiac Procedures
- Inpatient/outpatient surgery
- Non-emergency hospital/facility admission
- Organ/Tissue Transplant Services
Pre-notification enables Impact to inform the member about provider options and potential incentives available. If a member or their provider does not pre-notify Impact the member is subject to an additional co-pay of $1,000 for the illness or event.
HOW TO SUBMIT A BILL
In some instances, you may pay for your service up-front. In this case, you will request reimbursement from Impact.
You can do so electronically. Just use the link below to access the Member forms.
SHOULD THE PRA BE PAID UPFRONT?
The PRA is the annual amount a Member Household is responsible to pay for before eligible medical bills are approved for sharing. The PRA must be paid in advance of sharing.
These two exceptions are shared by members 100% even if the PRA has not been met:
• One annual physical
• $150 lab credit
Please note that all other eligible medical bills will only be shared into after the household PRA has been met.