What is a pre-eligibility review?
A pre-eligibility review is required before some treatments.
Pre-eligibility is required for any of the following treatments to be Eligible for Sharing:
- Cancer Treatment
- Elective Cardiac Procedures
- Non-Emergency Inpatient/Outpatient Surgery
- Organ/Tissue Transplant Services
- Maternity
- Imaging: MRIs and Nuclear Imaging (i.e. PET scans), not to include x-rays or ultrasounds
A 3-5 business day notice is required; expedited reviews may happen on a case-by-case basis. Medical records are required to determine pre-eligibility and failure to provide requested records for review will result in the bill being Ineligible for Sharing.
Which one do I need?
Pre-eligibility ensures that specific treatments are eligible for sharing before you receive them. Medical records are required for review.
Provider Outreach is for contacting your provider if they are unsure about accepting Impact Health Sharing.
Providers may request pre-eligibility by calling (855) 378-6777 or online here.
*This is not required for those in the Senior program.