Members can appeal bill sharing decisions under certain conditions.
Yes.
Impact evaluates each sharing request under these Guidelines. At times, the validity of a Member’s request may be unclear. In these situations, Impact must then exercise discretionary judgment, on behalf of the entire Impact membership, to evaluate the request, using common sense and fairness as a guide. Medical records may also be required to aid in determining if sharing is eligible.
Impact is likely to deny a sharing request, and possibly cancel membership, where any of the following occurs:
• Pre-existing conditions were not fairly disclosed during the application process;
• Relevant information appears to be obfuscated or changed during the sharing request process;
• A member is abusive to Impact staff during the processing of a sharing request;
• Failure to obtain requested medical records, and/or purposely withholding certain portions of medical records;
• Violation of the guidelines, indicating that intent was apparently not accidental; or
• Pre-approval for treatment for certain conditions was not obtained, where required.
To appeal a bill, email your medical records to medicalrecords@Impacthealthsharing.com. Remember to mention the bill number, date of service, bill amount, and why you're appealing. A third party will then review your records to make sure we handled your bill correctly. Once we receive the medical records, it will be reviewed by a 3rd party to ensure that we correctly processed the bill.