Liberty HealthShare, Inc.

After reviewing your membership, I see that we have shared all visits associated with 10/10/17. We have reached out to you by e-mail; we were unable to leave a voicemail.   Please get back with us so we can figure out what bills you are receiving, in hopes they are not balance bills of any...

kind. We would love to get this cleared up for you asap.

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint [redacted] and find that this resolution would be satisfactory to me.  I will wait until for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]

We do not have a network, which is why our members can go to any provider of their choice. Either they will bill us directly or our members can be a self-pay patient and submit their itemized information to us for processing. The provider you went to was willing to bill us directly, but at an...

increased rate, without accepting anything less. We shared the medical expenses, but they in turn, balanced billed you for the remaining amount. When working with balance bills, we are making sure our members are not paying for inflated prices; the process can take some time to be resolved. Your bills were submitted to a third party, who works solely on balance bills. When the provider would not accept anything lower than the billed amount, they then turned it over to their attorney for review. I see that our Research and Resolution team has contacted you and you are sending the receipts showing the payment arrangement you have made.  You will be reimbursed for the amount, since that voids us trying to negotiate the inflated price. As soon we receive that information, we will be able to process the remaining expense accordingly. If you have any additional questions about this, please reach out to our Research and Resolution Department.

We do offer our [redacted]rogram to potential members who may not meet the criteria for membership, which is outlined in the Guidelines. [redacted] would've been notified by one of our Health and Wellness  intake specialist to explain the program and let her make the decision, prior to accepting...

her as a member. The fact that [redacted] submitted medical bills that were not received, and she had to follow up by sending again, is a very unfortunate experience that I'm sorry she had to endure. We do accept bills via USPS, but I'm sure she was told that with no way of tracking them, if we didn't receive them, we wouldn't know they've been sent. It did take a couple contacts before we were able to confirm  we had received the bills. As I looked at these bills, I see that they were not coded as wellness, from her physician, which is why they were applied to her Annual Unshared Amount. If she called in about that, she would've had the opportunity to explain her situation and should've been notified to have her Physicians office resubmit them with the proper codes. I do see that our office reached out to her via phone or email, to follow up with her issues, on 6/2, 6/27 & 7/1, to which she did not respond. Our desire is that our members have the best member experience and I regret that she didn't. While it's not our practice to refund annual dues after 30 days, or monthly share amounts after 60 days, we will honor her request for a full refund.

After reviewing your membership, we have reprocessed your bills and checks will be going out to the providers. You can view the updated expenses online in your ShareBox. We apologize for any inconvenience this has caused you. If you have any further questions, please contact our Member Services...

Supervisor.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted]nd have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Dear [redacted] I have received your letter, thank you.Liberty Share sent me check on the name [redacted]I can`t use it and I told about that to them. They are playing game with me unwilling to pay for they mistakes.Hopefully it was mistake though I am not sure because there were many mistakes. Please, see my letter t[redacted] Thank you again for you help! [redacted]
[redacted]
 Hi, A[redacted] I have received your letter.
[redacted].You know perfectly that I can`t put this in my account.I told about that to your person when he called and he promised to issue another check. I requested $300 because I remembered that I spent $100 for ads.I printed flyers and also I had to pay for distant calls with [redacted] which supported to be free.I told him about that but I didn`t receive any response. I did not see emails from you or probably they were inside of [redacted] files as I was told I should check it.I don`t have time to go there, I am working full day.Instead of doing help for us and people you are creating headache for us.  I am reading here that you are going to send check for $400It was on  8/25 but today is 09/14I don`t have anything from you. I have to write to Revdex.com and other org, like [redacted] and [redacted]I suspect it is fraud and it is probably the whole your org. is scam. Best, [redacted]

When reviewing your membership, I see that we sent those checks out on 3/8/18. You can view the information online in your ShareBox and see the dates they were issued as well as the check numbers. If you have any additional questions or concerns, please contact our member services supervisor.

It appears that this potential member should have been elevated to a Supervisor or Manager, as what I am reading in their complaint should have had more research and discussion. I will have someone reach out to them today, to find out exactly what happened, and resolve this issue.

In checking into this membership, I do see that someone from our Research and Resolution Team has reached out to this member with an explanation of how each bill was shared. Although I cannot go into details due to HIPPA regulations, this member does have an Annual Unshared Amount of $1,000. ...

Several bills were applied to this amount.  Two medical bills were not shared since this is something we have written in our guidelines that we will not share in. I am including our guidelines regarding wellness visits.  All qualifying wellness visits were shared. Screening and Wellness Visits. Charges for one wellness exam or physical including physician fee per membership year, for which there are no medical symptoms or diagnosis in advance, including routine laboratory tests, radiology, and other ancillary services or procedures that occur during or as a result of the wellness visit are eligible for sharing, after the first 60 days of membership, up to a maximum of $400 of the fair and reasonable charges as determined by Liberty HealthShareSM and not subject to the Annual Unshared Amount (AUA). Pap smears are eligible for sharing once every year not subject to the AUA. Screening colonoscopies, PSA tests, and mammograms are eligible for sharing once every two years up to and including age forty-nine (49), and not subject to the AUA. Screening colonoscopies, PSA tests and mammograms for members fifty (50) years of age and older are eligible for sharing every year and not subject to the AUA. Well baby visits including immunizations are eligible for sharing within the first year after birth and not subject to the AUA. As far as refunding, a member can cancel in the first 60 days, and Liberty will refund, since that amount comes directly to LHS (this member has been a Sharing Member Since March 1, 2017).  After that, shares go directly to other members medical bills.  See below excerpt from Sharing Guidelines. During the first two months of membership, the share amount will be sent to Liberty HealthShareSM to be used at the discretion of the ministry. After that, members will be assigned an individual “Share Box ”, a secure online means of contributing their suggested monthly share amount directly to another member in need. Liberty HealthShare is unable to refund share amounts that have already been designated towards another member in need.

We are awaiting the additional information and sometimes that can take some time, depending on when your provider is able to send the information needed, for us to make a decision.  We will have our Appeal's supervisor reach out to you today. I'm not sure if the number we have on file for you is your cell, but she will call the number we have and email you as well. We want to get this resolved for you as quickly as possible.

When reviewing your membership, I see we processed your son’s medical expense on 2/28/18. The bill that was submitted to us had total charges of $3,932.00 and showed that you paid $982.99. The provider then wrote off the rest of the amount. That bill was one of the first ones applied towards your...

AUA, so you will not be reimbursed for it. The other amounts that you paid to the hospital were applied towards your own medical expenses, not your son’s. Those amounts are not eligible for sharing, as your pregnancy was pre-existing since you were pregnant before you enrolled with Liberty HealthShare. If you have questions on how the money you paid was applied, you will need to contact your provider.   We had a member of our Research and Resolution Team reach out to you and your provider to clarify this. I know it can be a little confusing when you are not used to Health Care Sharing, but we would like to make sure your billing concerns are addressed. If you have anything additional to submit, please reach out to the representative working with you.

Good Afternoon, I can understand your frustration when you sign up for something and it turns out to be something it's not. We are Liberty HealthShare, a Christian Health Care Sharing Ministry and we cannot find you anywhere in our system with your contact information. We do not start our...

memberships in the middle of the month and we do not have a sales representative by that name. We sometimes get confused with Liberty Health Insurance, but that is not who we are. If you did in fact sign up for us, Liberty HealthShare, we will be more than happy to assist you with this matter, please reach out to our Member Services Supervisor.

Our Research and Resolution specialist has reached out to you and your provider.  He will continue working on this until the issue is understood and resolved. If you have any additional questions, please reach out directly to the specialist handling your case.

We want to apologize for the issue you are having regarding your medical expenses. We have reprocessed your two bills for reimbursement and you will be able to view those in your [redacted]. If you have any additional questions regarding this issue, please contact our Member Services Supervisor.

When reviewing your membership, it looks like the provider send us the bill showing that you did not pay.   That is the reason it was originally sent to the provider. We have escalated your reimbursement and the check for $316.88 will be going out in the mail on 1/26/18. You will be...

able to check your ShareBox and see the updated information. If you have any additional concerns, please contact our Member Services Supervisor.

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:While I do not agree with the statements made by Liberty Healthshare regarding the handling of my account, I simply want to receive a full refund from them. With that being offered, I find the resolution to my complaint ID [redacted] satisfactory. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]

Our thoughts are with you as you and your family have gone through this tough time with your husband.   I am attaching the information from our guidelines for excluding an individual who does not list all medical information in full at the time of enrollment. Below that information, you will...

also find the appeal process as well.   Our thoughts are with you as you and your family have gone through this tough time with your husband.  I am attaching the information from our guidelines for excluding an individual who does not list all medical information in full at the time of enrollment. Below that information, you will also find the appeal process as well.  As a sharing ministry, we are always constrained by finite resources no matter how many members we may have. Existing medical conditions disclosed on an application can help us make suggestions as to spiritual or lifestyle changes that can improve the health of the individual and benefit the group as a whole. If, at any time, it is discovered that a Sharing Member did not submit a complete and accurate medical history on the Membership Enrollment Application or on the Medical History Questionnaire, either a sharing limitation or membership declination may be issued retroactively to his/her Enrollment Date. In such an event, annual dues paid at the time of application will not be refunded. Sharing Members may apply to have a sharing limitation removed by providing medical evidence that they qualify for such removal, however any removal will not apply retroactively. V. DISPUTE RESOLUTION AND APPEAL Liberty HealthShare SM is a voluntary association of like-minded people who come together to assist each other by sharing medical expenses. Such a sharing and caring association does not lend itself well to the mentality of legally enforceable rights. However, it is recognized that differences of opinion will occur, and that a methodology for resolving disputes must be available. Therefore, by becoming a Sharing Member of Liberty HealthShare SM , you agree that any dispute you have with or against Liberty HealthShare SM , its associates or employees, will be settled using the following steps of action, and only as a course of last resort. If a determination is made with which the Sharing Member disagrees and believes there is a logically defensible reason why the initial determination is wrong, then the Sharing Member may file an appeal.A. 1 st Level Appeal. Most differences of opinion can be resolved simply by calling Liberty HealthShare SM . A Member Services Representative will try to resolve the matter within 10 working days in writing.B. 2 nd Level Appeal. If the Sharing Member is unsatisfied with the determination of the Member Services Representative, then the Sharing Member may request a review by the Internal Resolution Committee, made up of three Liberty HealthShare SM officials: the Needs Processing Manager, the Assistant Director, and the Executive Director. The appeal must be in writing, stating the elements of the dispute and the relevant facts. Importantly, the appeal should address all of the following: • What information does Liberty HealthShare SM have that is either incomplete or incorrect? • How do you believe Liberty HealthShare SM has misinterpreted the information already on hand? • What provision in the Liberty HealthShare SM Guidelines do you believe Liberty HealthShare™ applied incorrectly? Within thirty (30) days, the Internal Resolution Committee will render a written decision.C. 3 rd Level Appeal. Should the matter still stay unresolved, then the aggrieved party may ask that the dispute be submitted to three randomly chosen Sharing Members, in good standing and chosen by Liberty HealthShare SM , who shall agree to review the matter and shall constitute an External Resolution Committee. Within thirty (30) days the External Resolution Committee shall render their opinion in writing. D. Final Appeal. If the aggrieved Sharing Member disagrees with the conclusion of his/her fellow Sharing Members, then the aggrieved party may ask that the dispute be submitted to a Medical Expense Auditor, who shall have the matter reviewed by a panel consisting of personnel who were not involved in the original determination and who shall render their opinion in writing within thirty (30) days.