Liberty HealthShare

After reviewing your membership, I see that the bill has been processedThe reimbursement for $is pending and awaiting a check to be assignedThis check will be mailed to you no later than next Friday 4/9/You can view the processed medical expense online in your ShareBoxWe want to
apologize for the inconvenience this has caused youYour wife cashed the other reimbursement you were referring to of $1,on 2/27/If you have any additional questions regarding this, 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:
I have reviewed the response made by the business in reference to complaint ** *** 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,
*** ***

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 todayI'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 wellWe want to get this resolved for you as quickly as possible

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 discussionI will have someone reach out to them today, to find out exactly what happened, and resolve this issue

We want to apologize for the miscommunication that you might have encounteredI do see that our Research and Resolution department has reached out to you and your providers, so your reimbursements will be going out in the mailIf you have any further questions or concerns, please do not hesitate
to reach out to our Research and Resolution team, or our Member Services Supervisor

The appeal you are referring to was reviewed and approvedAll your expenses were reprocessed accordingly as eligible for sharing; the bills you are receiving now would be balance billsBalance billing is when Providers bill you for the remaining amount because they refuse to take anything less
than the inflated billed chargesOur records indicate that you sent information regarding balance bills to MCS yesterday and a patient advocate has been into contact with you today regarding these billsWe will be sharing with one of these since that particular Provider is not willing to make any adjustments. We will be in contact with the remaining facilities. In the meantime, if you have any additional questions, please do not hesitate to reach out to the patient advocate that has been assigned to you Below please find an excerpt from our Sharing Guidelines regarding Excess Charges 5) Excess ChargesIn furtherance of the shared beliefs of all members, it is the mission of Liberty HealthShareSM to assist members to manage, control and direct their individual healthcare and the costs of that careThis includes the duty of each individual member of Liberty HealthShareSM to protect all members from unfair, unreasonable, or hyperinflated charges submitted by providers of healthcare servicesProvider charges must first undergo assessment of reasonableness, and if unreasonable, negotiations with health care providers will be required to be undertaken by Liberty Healthshare before being eligible for sharingMembers are expected to cooperate with Liberty HealthShare’s negotiation effortsLiberty HealthShareSM reserves the right, on behalf of its members, to determine what part of an expense for the care and treatment of an injury or illness is unfair or unreasonable, based on techniques, criteria and standards established or adopted by Liberty HealthShareSMIt is the intention of Liberty HealthShareSM to limit the sharing of charges determined to be unfair or unreasonable and may choose to advocate on behalf of Sharing Members against any healthcare service provider demanding payment of such unfair chargesIn this event, Liberty HealthShareSM will make concerted effort to encourage those physicians, providers, or facilities to agree to more reasonable prices, but if this is unsuccessful, the member will be notified by Liberty HealthShareSM that these practices/facilities are not willing to charge reasonable fees, and should the member continue to utilize these practices/facilities, they will be doing so with the understanding that the excess charges are their (the member’s) responsibility and future excess charges will not be eligible for sharing

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
I have just spoke with collections at *** *** *** they filed all my bills with Liberty Healthshare just after service was provided, some in 2017, and have received no compensation. ***a, the representative in collections at *** said they left messages yesterday with Liberty Healthshare as recent as yesterday 3/5/2018, and have had no response. Further more I still cannot access my "sharebox", which has been ongoing for 2018. I allegedly have been over charged by Liberty Healthshare for the last year up to $2000.00Does anyone know what is going on at Liberty Health Share??
Regards,
*** ***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ** ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
After speaking with several members of Liberty Healthshare, I have explained on MULTIPLE calls/emails with their representatives, mainly *** *** *** *** *** that the bill that was submitted was ONLY for my child's medical expenses, not my ownIn fact, I made this exceptionally easy for them to review because I requested to have my own expenses in a seprate hospital accountThe items detailed in the bill (attached) are only for the treatment and care of my newborn childI would like to know which of these items on the bill is not covered because they think it is related to my personal medical expensesThe bill CLEARLY states my child's name under the heading "Patient Name." I have also explained to Liberty Healthshare that the $credit card payment listed on the itemized bill was applied as a portion of a $deposit to *** *** to secure a discounted rate prior to being discharged from the faclityThis payment can be viewed in the attached January statement providedThe other portion of the $was applied to my hospital account, which was not sent to LibertyThe remaining balance for my child was paid IN FULL on the February statement (attached)I have confirmed wit* *** ***l billing representatives that the total bill for my child was NOT $as Liberty claims it to beWhen I questioned Liberty representatives whom they spoke with at billing, they were unable to answer me and said that they would follow up with me the following dayThey have not followed through on anything and I must continually persue them without any resolution to this problem. To say that I am unfamiliar with how a Healthshare works is condescendingI have read the guidelines and understand how the process worksThe problem is that hospitals don't recognize Liberty as any sort of payment option and the hospital will not send billing to them directlyTherefore, the patient must cover the expenses upfront and when it comes time for Liberty to reimburse a legitimate medical expense that SHOULD BE ELIGIBLE FOR SHARING, they come up with every excuse to delay processing a claim or will incorrectly process a claim, which is what has happened in this particular situation and why my bill was submitted for reprocessing in the first placeIf there is any discrepancy between my story and what Liberty claims to be true regarding this hospital bill, I will be more than happy to have a 3-way conversation with a Liberty representative and someone from *** *** billing department in order to achieve some sort of timely resolutionFYI, timely is not another - days without any correspondence on what is being done.In the meantime, Liberty should not tout themselves as a Christian organization, nor should they claim to be proficient in handling medical bills as their representatives and website have consumers to believeThe next course of action to resolve this problem is to have a Liberty representative, myself, and a *** ***l billing manager on the phone together to discuss this bill so that ALL PARTIES are equally informed in how to proceed
Regards,
*** ***

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 resolvedIf you have any additional questions, please reach out directly to the specialist handling your case

After reviewing your membership, it looks like you had a primary insurance and the bill was pended for the EOB from the primary insuranceI see that the hospital reduced the bill amount to $2,and you paid that directly to themI had this processed for you and the check will be going out in
the mail by this Friday 2/9/18. I apologize for any inconvenience this may have caused Regarding your request to be refunded for your monthly shares, I see that you are still an active member of Liberty HealthShareEach sharing member’s monthly share goes towards others members eligible medical expensesThe only time that we are able to refund, is if someone were to cancel within the first days of membershipBelow is how we assign the monthly shares Assigned NeedEach month a Sharing Member is assigned a specific need in which to shareBy submission of the suggested Monthly Share Amount, the member instructs Liberty HealthShare SM to assign his/her contribution as prescribed in these Guidelines, which set forth the conditions upon which Sharing Member medical expenses will be sharedBy participation in the Program, the Sharing Member both accepts those conditions as enforceable and binding within the program for the assigning of his/her contribution, and designates Liberty HealthShare SM as the final authority for the interpretation of these Guidelines If you have any additional questions regarding this, please contact our Member Services Supervisor

We requested records from your providers, but they were never received. However, after reviewing your membership today we see you were a sharing member for months so this was considered a new incident and your bills were processedYou will be able to see this information in your ShareBox
You will only be responsible for the first $of medical expenses each membership year and we will be sharing with the remaining amountsWe want to apologize for any inconvenience this might have causedIf you have any additional questions, please reach out to our Member Services Supervisor

This member does have a legitimate concernWe do not bait and switch, and would not want to make decisions that would give any member that impressionHowever, because his concern was not addressed appropriately, he obviously felt that is what was happeningThe time frame in which our different
messages were emailed and mailed did fall outside the time frame in which he became a memberThe Member Services Supervisor is contacting him to resolve this

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 sharedAlthough 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 inI am including our guidelines regarding wellness visits. All qualifying wellness visits were sharedScreening and Wellness VisitsCharges 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 days of membership, up to a maximum of $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 AUAScreening 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 AUAScreening 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 AUAWell baby visits including immunizations are eligible for sharing within the first year after birth and not subject to the AUAAs far as refunding, a member can cancel in the first 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 GuidelinesDuring the first two months of membership, the share amount will be sent to Liberty HealthShareSM to be used at the discretion of the ministryAfter 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 needLiberty HealthShare is unable to refund share amounts that have already been designated towards another member in need

We want to apologize for the issues you have had with your medical expensesI do see that a member of our Research and Resolution department had tried to reach out to you to let you know we contacted your providers and they are not placing you in collectionsWe have escalated your medical expenses
so we will be getting the checks out as quickly as possible to you for reimbursement If you have any additional questions, please do not hesitate to reach out to the specialist working on your membership

After reviewing your membership, we have reprocessed your bills and checks will be going out to the providersYou can view the updated expenses online in your ShareBoxWe apologize for any inconvenience this has caused youIf you have any further questions, please contact our Member Services
Supervisor

Thank you for bringing to our attention, our member's concern about our businessAs you can see by the attached correspondence documentation, the member called in on July 30th, and sent a Contact Us question stating his concernsOn August 3rd he received an email from our representative stating
how we would be responding to his request, which he confirms receiving via a Contact Us communication on August 24thHe did mention, in that communication, there was an error, and the following day, August 25th, a correction was made. Please let me know if you need anything further

We received a call from you asking us to send the checks directly to the provider and not as reimbursement to youWhen we reprocessed the request, it created a different date because we had to modifyIn doing that, it did delay the checks from immediately going outThe updated batch has been
created and the checks will be mailed to the provider in the amount of $for the date of service to which you are referringThe entire amount is not being shared because there is a code on one of your bills that is not eligible for sharing under our guidelines If you have any additional questions, please do not hesitate to reach out to our Member Services Supervisor

On 2/19/we responded to you that your expenses had been reprocessedThe bills just had a check assigned to them and they will be going out in the mail tomorrowA member of our Research and Resolution team will be in contact with you today regarding these expensesOur records indicate you had two active membership so our IT staff has now corrected this problem. You should be able to log into your ShareBox at this time Please reach out to our Member Services Supervisor if you have any further issues

We have not denied it for pre-existing, we are just requesting additional information to determine eligibility of the MRIWe need to know that this injury is a new incident and not related to an injury that has occurred months prior to your membership beginningOnce we can get the information from the provider that it a new injury and not related to a previous one, we will advise the provider the provider will be eligible for sharing

After reveiwing your account, I see we have tried to reach out to you several times in the month of JulyFor us to resolve these billing concerns, your account was turned over to our research and resolution teamThey can be reached at *** *** ***