If you have been a Liberty HealthShare member for a while, you might already know how to submit a bill or receipt through your online ShareBox. You also may or may not have encountered an issue with what's known as "balance billing." For those of you who are new to Liberty, or if you simply are not familiar with these two topics, here’s a quick refresher:
“Submit Medical Expense” is a feature in your ShareBox that allows you to electronically submit bills you have received or paid. Click on "Submit Bill/Receipt" in your ShareBox overview, and you will be taken to this page:
- At the bottom of this page, there is a step-by-step tutorial video you can view if you need any help.
While we’re on the topic of billing, let’s talk about "balance billing.” Simply put, this is what happens when a bill has been paid and a provider then attempts to get more money directly from the patient. Although this is rare, it does happen.
The payment schedule Liberty HealthShare uses to compensate providers for their services has been shown over time to be simple and fair. Every provider in the nation is familiar with Medicare, and Liberty’s pay schedule simply uses the Medicare reimbursement as a baseline to which we add an additional 50% to 70%, depending on the type of provider. Even if a provider does not agree to Liberty’s pay schedule, we can negotiate a rate with which they feel comfortable. Once a provider agrees to the payment schedule, bills are then submitted and paid through our community or directly from the member if that payment applies to their annual unshared amount (AUA).
For a provider to agree to the payment Liberty offers and then come back to the patient for more money is unethical, and there is no reason why a patient must pay the additional cost. It clearly states on the reverse side of every Liberty HealthShare membership card that once a provider accepts payment from LHS on behalf of a member, they cannot seek further payment from the member. This can and will be upheld by law.
So what should Liberty HealthShare members do if they are balance billed?
First, if you receive a bill from your provider in the mail, check your online ShareBox. In the Medical Expenses section, you will be able to see any expenses that we have received on your behalf. The bill that you received might be an expense that goes toward your AUA. It will be reflected in your online account and will show up under AUA. This is a case in which you are being billed correctly, and you will need to pay your provider directly.
However, if it is a bill that is not reflected in your ShareBox, then Liberty Healthshare has not received that bill, and it is likely balance billing. Send a copy of your bill to MedCost Solutions (MCS) right away, either by e-mail at firstname.lastname@example.org or by fax at (234) 214-0906, and their Advocacy Team will help with next steps. It's important that you do this immediately, and before you respond in any other way. If you have questions for the MCS team, you can contact them at (330) 426-8866. For more information, refer to the letter enclosed with your explanation of sharing.
Unfortunately, balance billing has become a practice in which many providers engage. It’s intimidating, and members may end up paying those bills without knowing they are not required to pay. We urge you to communicate with us about any billing you receive. If you have been balance billed, our legal team will work on your behalf for as long as it takes to settle the debt. We are here for you and are ready to support you.
- Submit a Bill in Your ShareBox: