Typically, this can occur if the doctor has had a negative experience with another healthcare sharing organization.
Although this is rare, it is possible. If a provider has questions, it's best they call the toll-free number on the back of the member ID card and follow the provider-specific prompts. The Impact specialist will explain the program in further detail and negotiate if necessary. If they don't want to call, you can print this provider letter to take with you.
If a provider denies service, you, as an Impact member, have options.
- If you're appointment is at least 72 hours out, submit a Provider Outreach Request.
- Simply fill out the online form: Provider Outreach Request.
- Our Provider Outreach Team will:
- Contact your provider directly to discuss our billing process.
- Provide clear instructions for submitting claims electronically.
- Offer a downloadable guide for their convenience.
- Answer any questions they have about working with Impact.
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SELF-PAY
If your healthcare provider requests payment in advance, proceed with the payment and then submit your receipt and bill to Impact using the Medical Expense Form. When you pay cash, ensure you obtain a HCFA, UB, or at the very least, an itemized bill. Don't forget to ask for a 'cash pay' discount or 'self-pay' discount, as these can significantly reduce your out-of-pocket expenses.
Eligible medical bills will either be applied towards your Personal Responsibility Amount (PRA) and co-share or, if your PRA has already been met, they will be published for sharing and subsequently reimbursed.
If these costs are from your annual physical or $150 lab allowance, you will be reimbursed once the bill is processed. No need to meet your PRA first.
- In some cases, your provider may send you the bill later. When you receive the bill, submit it as a Medical Expense, and it will be put through our repricing process. Our team may be able to negotiate a better price for you.
Watch this helpful video for more details