We understand that being a Health Share member is new for many ShareWELL members, and accessing care can initially feel intimidating, especially during an emergency. Rest assured, we're here to guide you through every step of your emergency room visit as a self-pay patient.
Step 1: Declare Yourself as a Self-Pay Patient
As a ShareWELL member, you'll be considered a self-pay patient. This status allows you to take advantage of self-pay discounts and ensures you're billed directly for any expenses related to your visit.
When hospital staff ask for your insurance or ID card, simply let them know you're self-pay and request that the bill be sent directly to you. Keep in mind that you won't need to make any payments that day. The hospital will provide your bill by mail or through a patient online portal, and we'll guide you in handling it once it arrives.
Step 2: Open a Sharing Request
After your emergency room visit, it's important to open a Sharing Request with ShareWELL as soon as possible. This step is essential to start the determination process for sharing with the ShareWELL community.
To get started, visit the Submitting a Sharing Request page and complete your request.
Step 3: Confirm Your Bill's Eligibility
Once you've submitted your Sharing Request, we'll review it to determine eligibility for sharing. You may need to sign a HIPAA form, which permits us to gather the necessary medical records from your provider.
Review the Member Guidelines to ensure your expenses qualify for sharing.
Step 4: Negotiations
ShareWELL Partners will evaluate your bills for accuracy and fair pricing. Do not pay your bill until we notify you to do so. This allows our team to assess whether there's an opportunity to negotiate for better pricing or resolve billing issues.
Our negotiation process may include:
- Instructing you when and how to pay your Unshared Amount (UA)
- Reviewing bills for duplicate charges, errors, or inflated pricing
- Identifying additional self-pay resources to reduce costs
- Engaging in attorney-led negotiations, when appropriate
If we determine that negotiation support is possible, we'll guide you through providing all necessary documents, including itemized bills and financial records. Your timely response is vital. ShareWELL members are expected to act quickly when our team requests information or signatures so we can advocate effectively on your behalf.
Step 5: Submit Your Bills and Communications
Emergency room visits often generate multiple bills from providers, including the hospital, emergency physicians, radiology, and lab services. Please submit all bills and any communications you receive to ShareWELL:
- Itemized bills
- Provider statements
- Self-pay status determinations
- Visit notes
- Payment receipts (if applicable)
Complete submissions allow us to process your request quickly and ensure your eligible expenses are handled properly.
Putting It All Together
We know emergencies can be stressful, but following these steps will help make the process more manageable: declare yourself as a self-pay patient, submit your Sharing Request promptly, allow our team to evaluate and negotiate your bills, and provide all documentation in a timely manner.
By working together, you can make the most of your ShareWELL membership and secure fair pricing with less stress.