BASIC TERMS UNIQUE TO IMPACT HEALTH SHARING
Contribute or Contribution. The dollar amounts voluntarily transferred by a member to Impact for continued participation in the Impact Health Sharing program. Since participation in the Impact Health Sharing program is not a contract for insurance and participation is voluntary, contributions are not a demand for payment for a product or service.
Invoice or Statement. A demand for payment for medical care services rendered, submitted by a medical care provider to a member.
Pay or Payment. The dollar amounts tendered to a medical care provider or facility by Impact or a member under the Impact Health Sharing program in consideration for a medical care service rendered by the provider to a member under the provider’s contract for service.
Share or Sharing. The joint sharing of certain medical expenses incurred by a member that are contributed to by other members of the Impact Health Sharing community.
Share Notice or Notice. A notification of voluntary contribution amounts due under the Impact Health Sharing program, submitted by Impact to a member. Share Notices are typically delivered monthly as a Monthly Share Notice.
IMPACT PROGRAM AND MEMBERSHIP
Bill Approved for Sharing. An Eligible Medical Bill that meets the criteria for sharing under the Guidelines and meets all of the other conditions for sharing, including whether the member’s Primary Responsibility Amount (PRA) has been met and other sharing limits have not been exceeded.
Cancellation Date. The month and day the membership ends due to the member’s withdrawal, or an administrative cancellation.
Effective Date. The date the member’s current PRA began.
Eligible for Sharing. Any testing, treatment, procedure or service, determined eligible in having met the criteria for Sharing under the Guidelines.
Eligible Medical Bill. An incurred medical bill that meets the criteria for Sharing under the Guidelines. The Eligible Medical Bill may be reduced by any discounts, fees, or other sources of payment.
Federally Illegal Drugs. Drugs that are classified as Schedule 1 in Title 21 United States Code (USC) Controlled Substances Act.
Member. Any member of the Impact Health Sharing program, including each family member participating in a Member Household.
Member Household. The related family members participating in the Impact Health Sharing program.
Membership Date. The date a member’s participation in Impact begins. Medical bills incurred after this date may be considered for Sharing between the members.
Preexisting. Any diagnosis, testing, medication, or treatment of a condition that a member has received before their initial Effective Date with Impact.
Primary Member. An adult member who is the main contact for the Member Household.
Primary Responsibility Amount (PRA). The dollar amount a Member Household must pay toward their own Eligible Medical Bills during a 12-month period before their Eligible Medical Bills can be Published and Shared by the Membership. The PRA 12-month period begins on the Membership Effective Date.
Provider Fee. The portion of a medical bill that a member pays to a healthcare provider at each visit.
SHARE ACCOUNT ACTIVATION
Auto-Share (Recurring EFT). A Sharing Permission enabling a Primary Member to set up recurring Electronic Funds Transfers (EFTs) in order to transfer the Total Share Amount Due as specified in their Monthly Share Notice.
External Account. An existing bank account that is linked to the Primary Member’s Share Account and is used to transfer the Total Share Amount Due via EFT into the Share Account each month.
Manual Share. A function that enables a Primary Member to initiate an on-demand EFT in order to transfer the Total Share Amount Due as specified in their Monthly Share Notice.
Permissions. Auto-enabled functions (e.g., Auto-Share) that are set and managed by the Primary Member.
Share Account. The member-controlled virtual account that is linked to both your External Account and your deposit account at America’s Christian Credit Union and is used for all Sharing transactions and activities.
MONTHLY SHARE NOTICE
Grace Period. The number of days between the Share Due Date and the Past Due Date.
Monthly Share Amount. The sum of the Share Portion and Required Miscellaneous Portions Published in the Share Notice.
Past Due Date. The day of the month that a delinquent Total Share Amount Due becomes past due.
Past Due Reminders. Share Notice Reminders sent to a member who has not paid their Monthly Share Amount and their Total Share Amount for the month is past due.
Payment Reminders. Share Notice Reminders sent only to a member who pays manually, instead of automatically, and only if the Total Share Amount Due has not been paid.
Previous Balance. The sum of any past due, unpaid amounts published in the Share Notice.
Required Miscellaneous Portion. An amount set by the HCSO to fund certain described activities, such as its administrative and program expenses.
Share Due Date. The day of the month by which the Total Share Amount Due must be transferred in full by EFT.
Share Notice. The written notification to a member that details the Total Share Amount Due for the month.
Share Notice Date. Similar to a statement date or invoice date, it is the day of the month that the Share Notice is published and distributed.
Share Payment (Funding). Transferring funds (Total Share Amount Due) from a member’s External Account to their Share Account.
Share Portion. The portion of the Monthly Share Amount that is collected and used specifically for member-to-member Sharing of Eligible Medical Bills.
Total Share Amount Due. The sum of the Monthly Share Amount (Share Portion and Required Miscellaneous Portion), Optional Portion (auto-enabled by the member), service fee, and any past due amount (Previous Balance).
MEDICAL BILLS AND NEEDS
Adjusted Amount. The discounted or repriced amount.
Approved for Sharing. The portion of the Adjusted Amount that is eligible for Sharing under the Guidelines.
Bill Status. References the processing stage/state of a specific Need or Eligible Medical Bill.
Charge Amount. The gross amount billed by a medical provider.
Explanation of Sharing (EOS). A notice sent to a member detailing the eligibility status of a bill, any discounted amounts, and what portion of the remaining Charge Amount has been shared by the Impact members and any remaining amount that must be paid by the member.
Member Responsibility. The portion of the Adjusted Amount calculated to be the member’s responsibility and not to be Shared.
Need. A grouping of medical bills by a medical event, such as knee surgery. Individual medical bills may sometimes be referred to as a Need.
Published Amount. The portion of the Adjusted Amount that is eligible for Sharing and has been Published to the members for Sharing.
Received Date. The date that Impact receives the medical bill and begins processing the bill for eligibility.
Service Date. The date that the member (patient) received services from the medical provider.
Shared Amount. The Published Amount that has been Shared and collected in the member’s Sharing Account.
MATCHING AND SHARING
Sharing (member-to-member transfers). Moving funds from a sending member’s Share Account to a receiving member’s Virtual Bill Account.
SHARE ACCOUNT
Available Balance. The total sum that is available for sharing a new Eligible Medical Bill or withdrawal. It is the Total Balance, minus the Pending Balance, minus the Restricted Balance.
Debits and Sharing. The negative (-) transactions debited out of a member’s Share Account, which would be the Required Miscellaneous Portion (i.e., debits), Optional Portion, and Share Portion.
Deposits and Credits. The positive (+) transactions that are credited to a member’s Share Account, such as EFTs (i.e., deposits) and Shared Funds Received (i.e., credits) that a member might receive to pay their Eligible Medical Bill.
Pending Balance. The sum of EFTs that have been initiated, but have not yet posted to a member’s Share Account.
Restricted Balance. The sum of funds that have been credited to a member’s Share Account for the purpose of paying an Eligible Medical Bill.
Total Balance. The sum of the Pending Balance, Restricted Balance, and Available Balance in a member’s Share Account.