Last month, you as members of Liberty HealthShare were given an opportunity to share your input on a number of proposed changes to our Sharing Guidelines. If you participated in this Member Advisory Vote, thank you. Your feedback is an important factor as we regularly evaluate how we can best serve our members.
Based on your input the Board of Directors has determined the following changes will take effect on February 1, 2019:
- There will be no change to the sharing guidelines for Complementary and/or Alternative Medicine (CAM) or for Naturopathic, and/or Alternative Treatments. Parameters are as follows: Treatment provided by a naturopathic physician or doctor of naturopathy (ND or NMD), a traditional naturopath or other practitioner of alternative treatments is eligible for sharing or at least partial sharing if such treatment meets the following criteria:
- It treats a medical condition diagnosed by an MD or DO.
- It is less invasive than conventional medical treatment for the diagnosed condition (as determined by our medical staff).
- It is less costly than conventional medical treatment and is expected to prevent more costly future conventional treatment.
- It is presented for prior approval to Liberty HealthShare and the member agrees to any alteration of the treatment plan made by Liberty HealthShare.
- Medical bills must be submitted within 120 days of the date of service in order to be shared.
- Note: If you are a sharing member who does not receive a bill until after this 120-day window has passed, you should still submit it for sharing. You will then receive instructions for an easy process to demonstrate the bill was received late so it can still be designated eligible for sharing.
- Liberty HealthShare will no longer conduct a case-by-case review of experimental, investigational, unproven, or unapproved services that have been designated as ineligible for sharing.
Based on information we gathered from members and our medical services team throughout the year, the following change is also in effect to better serve members:
- When a sharing member is prescribed physical therapy (PT), occupational therapy (OT), speech therapy (ST), or respiratory therapy (RT), up to 12 visits (formerly 10) per membership year for each instance of PT, OT, ST, and/or RT by a licensed therapist are eligible for sharing. After the initial evaluation, pre-notification and approval by Liberty HealthShare are required before any needs for therapy will be considered for sharing. An additional 8 visits may be eligible for sharing after a reassessment, for a total of 20 visits per membership year.
This announcement is meant to serve as a quick update on changes to our guidelines, but it is not comprehensive, as there are additional clarifications contained within the Sharing Guidelines document. As a sharing member, it is your responsibility to familiarize yourself with the Sharing Guidelines and reference them as often as you need to.
We expect that these changes will help us in our pursuit of excellent service and stewardship of the funds you give to share in one another’s medical bills. We are thankful for your membership and your input as we continually evaluate how best to serve you.
If you have any questions, concerns about these changes, please contact us at firstname.lastname@example.org