Skip to content
Close
SEARCH
CONTACT
PHONE HOTLINE: (855) 378-6777
ENROLL NOW
PHONE HOTLINE: (855) 378-6777
ENROLL NOW
Happy little boy after health exam at doctors office_592

Going to the Doctor

Getting Care Is Easier Than You Think

At Impact, you’re never just a number—you’re part of a community that truly cares for one another. And when it comes to getting care, we keep things as simple and stress-free as possible.

You have the freedom to see any provider you choose—no network restrictions, no red tape. Whether you're going in for a routine visit or preparing for a procedure, these step-by-step guides show you exactly what to do next.

How to Get Care: Member Guide (PDF)
How to Get Care: Senior Member Edition (PDF)

  • 1: CHOOSE A PROVIDER

    With Impact, you have the freedom to choose your provider. There are no network restrictions or red tape.

    Senior Members: You may see any Medicare-participating provider. Just let them know you’re part of a health care sharing organization, not insurance.

    Need help finding or confirming a provider? Our team is here to support you—we're here to help.

  • 2: SHOW YOUR MEMBER CARD

    At each appointment, be sure to show your Impact member card, which includes all the billing information your provider needs.

    If your provider isn’t familiar with Impact or asks you to pay upfront, don’t worry—both situations are common and neither prevents you from using your membership or seeing the provider of your choice.

  • 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.

    Provider Fees: (also listed on your member card)

    • $0 virtual telehealth visits
    • $0 annual wellness visits (one per member, per year)
    • $50 primary care visits
    • $75 urgent care, specialist and outpatient visits
    • $150 emergency room visits or inpatient hospitalization.  

  • STEPS TO SHARING

    When you get medical care with Impact Health Sharing, your doctor may bill Impact directly or ask you to self-pay. 

    Whether you submit your bills for sharing directly to Impact or your provider submits them to us, you are still saving with Impact and seeing the provider you choose.

     

  • OPTION A:

    DIRECT ELECTRONIC BILLING

    In most cases, providers bill Impact directly, and we work with them to coordinate eligible healthcare costs on your behalf.

    To be shared with the community, bills must meet eligibility guidelines, and your annual Primary Responsibility Amount (PRA) must be paid.

    Exception: Your complimentary annual wellness visit and up to $150 in routine labs per member, per year are shared 100% by the community—and available starting day one of your membership.

  • OPTION B:

    SELF-PAY

    If your provider asks for payment upfront, that’s okay—you can still use your Impact membership.

    Pay the provider directly, and be sure to request a discount by asking for the “self-pay” or “cash-pay” rate—this can significantly lower your cost.

    Collect proper documentation, such as a HCFA form, UB form, or at minimum, an itemized bill. Submit your bill and receipt through the Bill Submission Tool in your Member Center.

    If the bill is eligible, it will either:

    • Be applied to your annual PRA and co-share

    • Or, if your annual PRA is already met, it will be published for sharing and reimbursed

  • REMINDER: For annual wellness visits, consider using the free Wellness Concierge Service—it helps coordinate payment before your appointment, so you can skip the paperwork and focus on your health.

Can we help?

Absolutely. We offer two types of support to help coordinate your care—based on the type of visit and your provider’s billing preferences.

Here’s how to know which service is the right fit for your situation.

 

Use the Wellness Concierge for...

  • Your annual wellness visit only

  • Impact coordinates billing and payment directly with your provider before your appointment

  • An easy and effective way to introduce Impact to your provider

Choose this if: You’re booking your yearly wellness visit and want help handling the paperwork ahead of time. A minimum of five business days notice is required. 

Learn More About the Wellness Concierge ➝

Use Provider Outreach for...

  • Any visit outside your annual wellness exam

  • Providers who are unfamiliar with Impact or unsure how to work with us

  • Help navigating questions or concerns from your provider

  • Any instance where your provider says they won’t bill Impact directly

Choose this if: You already have an appointment and your provider needs clarification—or is hesitant to work with Impact.

Please make sure your appointment is at least 72 hours out from submitting the form so our team has time to contact and connect.

📞 If your situation is urgent, call us at 855-378-6777.

Not applicable for participants in the Senior Program.

Request Provider Outreach ➝

How it works

What do I do when I need to go to the doctor?

Steps to take to see any provider when you need care.
Bill Review

WHAT CAN I EXPECT?

At Impact, we do things differently—and better. Our electronic bill review, digital sharing platform, and distributed medical reserves allow us to pay providers typically within 15 days of receiving your bill.

This industry-leading efficient process helps set Impact apart from other healthcare sharing organizations your provider may have encountered—and it’s designed to make things smoother for everyone involved.

If your provider needs more information download the Provider Outreach Letter below or simply have them give us a call—we’re happy to help.

  PROVIDER OUTREACH LETTER
 
 
 

  • We find that it is most efficient for medical providers to submit bills for their services electronically through EDI and to the Payor ID located on the back of the member card.
  • This allows Impact Health Sharing to review and adjudicate medical bills for eligibility per the Program Guidelines quickly. Most bills are in review less than 15 days.  
  • Once reviewed for eligibility, Impact Health Sharing's technology platform  facilitates member sharing from 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., Annual PRA, Co-Pays, or Co-Shares) and delivers an EOP (Explanation of Payment) to providers detailing the amount(s) paid. 
 

PRE-ELIGIBILITY

As an Impact member, you have the freedom to see any provider—and there are no utilization reviews. That means Impact trusts you and your provider to make the right decisions for your care.

However, for certain non-emergency situations, providers must request pre-eligibility to ensure the services are eligible for sharing.

These include:

  • Cancer Treatment
  • Elective Cardiac Procedures
  • Non-emergency inpatient/outpatient surgery
  • Organ/Tissue Transplant Services 
  • Maternity

  • Imaging: MRIs and Nuclear Imaging (i.e. PET scans)

Providers  may apply for pre-eligibility online or by calling (855) 378-6777. 

Please allow 3–5 business days for the pre-eligibility review. Expedited reviews may be available on a case-by-case basis—just contact us to discuss your situation.

Medical records are required to complete the pre-eligibility review. If requested records aren’t provided, the bill will be ineligible for sharing with the community.

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 go to the Member Center to access the Bill Submission tool.

Forms
medical-bill

DOES THE ANNUAL PRA HAVE TO BE PAID UPFRONT?

The Primary Responsibility Amount (PRA) is the total that each household must pay annually toward your eligible bills before any additional expenses become eligible for sharing with the member community. So yes, the annual PRA has to be paid in advance of sharing but depending on the bills incurred, you may not owe it all at one time. 

In addition, it's important to know that the annual household PRA can only be met with eligible bills and through the Wellness Rewards program. Please note that all other eligible medical bills will only be shared into after the annual household PRA has been met.

There are two exceptions shared 100% by the community and available day one of membership, regardless of annual PRA status:

• One annual wellness visit per member
• up to $150 for routine labs per member, per year

Learn More.

Blog Images - Impact (14)-1

MORE QUESTIONS?

We're here to help! 
 
(855) 378-6777