What is Reference-Based Repricing?

Reference Based Repricing ensures fair and just pricing for all bills.

Our approach includes three key components to ensure claims are priced fairly for everyone involved.

First, we audit each bill using our industry-leading Medical Bill Review program. This helps us identify any inaccuracies or inconsistencies in the billing process.
Next, we determine the "best price" for each bill using multiple methodologies and 20 years of bills history. This includes utilizing historical data, reference-based benchmarks, direct contracts, fair market value, and fee-for-service pricing.
Finally, we determine what is considered fair-marketing pricing for the services rendered.

98% of the time, the provider accepts the initial payment from Impact Health Sharing. However, we know that some providers have billing systems configured to automatically generate balance bills to patients if they receive a payment for less than the initial billed charges. If this happens, it's important that our members call us right away. Once we have been notified, we will work directly with the provider to settle the account through further negotiation.

At Impact Health Sharing, we are committed to providing fair and just pricing for all of our members. We believe that by utilizing our Reference Based Repricing process, we can ensure that members receive the best possible care and have a positive member experience.

In addition, whenever a medical bill is determined not to be ineligible for sharing, it is still reviewed through the same rigorous Reference Based Repricing process. This means that even if a bill is for a pre-existing condition and can't be shared by the community, Impact Health Sharing will still advocate for the member by working to secure a fair market price. This approach helps protect members from unnecessarily high charges and demonstrates our commitment to ensuring equitable healthcare costs, regardless of a bill’s eligibility for sharing.