Liberty HealthShare and Maternity

December 17th, 2020

Liberty HealthShare and Maternity

Preparing for the arrival of your little one is very exciting, but it can feel overwhelming at times, especially when trying to navigate your healthcare.

As a Liberty HealthShare member, your maternity experience will be unique and your community will be here to support you during this time. We have efficient processes in place to help you smoothly transition throughout your pregnancy and post-pregnancy journey, to provide the best care for you and your growing family. We often hear our members ask how their healthsharing membership will work with their upcoming maternity expenses and how they can receive the most value from their healthcare.

In this article, we offer answers to some of our frequently asked questions regarding maternity and how it relates to our current Sharing Guidelines at Liberty HealthShare.

How will Liberty HealthShare support me during my pregnancy?

A Maternity Facilitator is assigned to you after you contact our Prenotification department with the news that you are expecting. Soon after, your facilitator will send you a welcome email that includes information related to your maternity care and contact information. They will contact you to discuss your plans for delivery and answer any questions you have related to sharable expenses.

If you do not receive a welcome letter from a maternity facilitator within 7-10 days of your initial call to let us know you are expecting, please check the spam folder in your email and the membership area of your ShareBox to ensure that your contact and email address is correct. If you find that you still have not received the welcome email, please give us a call.

Which services related to my pregnancy require prenotification?

  • As soon as you become aware of your pregnancy, you must complete a prenotification request. Eligibility for your pregnancy must be confirmed by our prenotification team in order for your maternity expenses to be eligible for sharing. Keep in mind that members must be enrolled before conception for maternity to be eligible for sharing.
  • If your pregnancy is determined to be high-risk, additional prenotification is not required unless further intervention outside of normal prenatal care or hospitalization is deemed necessary.
  • Delivery or induction does not require a separate prenotification.
  • Planned circumcision for newborn boys does not require additional prenotification: it is included under the mother’s maternity prenotification.

Which maternity-related services are NOT shareable within the Liberty HealthShare community?

The following services are not eligible for sharing with your Liberty HealthShare membership:

  • Genetic testing
  • Doulas
  • Birthing tubs or liners
  • Tubal ligations or sterilization

Breast Pumps are not shareable through your sharing program; however, your Maternity Facilitator will provide you with information about discounted breast pumps. In addition, two lactation consultations are eligible for sharing post-partum.

How do I submit expenses for maternity care?

You should submit your eligible medical expenses for maternity care like any other expense. Submitting your medical expenses with all the required documentation helps us to facilitate your medical expenses. When submitting, you will need:

  • Patient name
  • Itemized invoice/statement/agreement
  • Receipt of any payments made to the provider for this expense
  • Type of service/CPT procedure code
  • Diagnosis code (ICD format)
  • Charge for the service
  • Date of service
  • Healthcare professional’s name/credentials and address

 You can read more about the how to submit a bill and watch a helpful video here.

How will my eligible maternity expenses be applied to my Annual Unshared Amount (AUA)?

Your AUA is the amount of medical costs that you are responsible for before sharing can take place. All eligible maternity expenses will be applied to the member’s AUA according to the date of service.

In some instances, a member’s AUA will renew during their pregnancy due to their membership renewal date. If this occurs, the member could potentially have to meet their AUA twice during their pregnancy in order to be eligible for sharing.

      Example:  Pregnancy Estimated Due Date: 10/31/2020 
                        Membership Renewal Date: 8/1/2020
In this instance, the member would be required to satisfy their AUA for any expenses with a date of service occurring during their membership year of 8/1/2019-9/31/2020 AND for expenses with date of service occurring after membership renewal of 8/1/2020.

If your provider offers a discount as part of a global maternity package, a portion of your maternity expenses may be shared by members early in your pregnancy and/or after delivery. This may also impact how your expenses are applied to your AUA.

My provider/hospital will not bill Liberty directly, what do I do?

If your provider or facility will not bill us directly, ask them for written estimates for a self-pay discount. OB/midwives may offer global maternity packages that include prenatal, delivery and post-partum care for a flat rate. Please communicate and inquire with them about this.

You can also ask the provider if they would be interested in entering into a single case agreement with Liberty HealthShare. In this circumstance, a pricing agreement is reached prior to any medical service being performed, and sharing of those expenses occurs within the terms of the agreement. Please provide your maternity facilitator with your provider’s contact information so we can help in negotiating the best pricing for your services.

My provider/hospital expects payment prior to delivery, what do I do?

Please contact your Liberty HealthShare Maternity Facilitator to determine your options.

I recently delivered my baby, what do I need to do now?

You must add your newborn to your Liberty HealthShare membership within 30 days of birth. If your baby is not added to your membership within this timeframe, any expenses incurred for your baby will not be eligible for sharing.  To add your newborn to your membership, please contact the Enrollment department at 855-585-4237 ext.1768.

If your baby requires additional care and hospital stay (NICU), please ensure your baby is added to your membership AND contact the prenotification department to prenotify the NICU stay.

As always, Liberty HealthShare is here to support you during your health journey and this includes maternity care.

 

 

 

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