Reply from Liberty HealthShareApr 9, 2024
Dear Vicki,
Thanks for sharing your feedback and for speaking with our Leadership Team regarding this matter. We apologize for any inconvenience this has caused you. The easiest way to submit a medical expense, if your healthcare provider does not submit it for you, is to request an HCFA-1500 or UB-04 from the provider. These are standard billing forms used by providers and the optimal approach for receiving all the necessary processing information. All itemized statements require: CPT/procedure codes, DX/diagnosis codes, Revenue Codes, NPI/National Provider Identifier, and provider Tax ID. Regarding eligibility, Eligible Medical Expenses will only be shared for Active Sharing Members in good standing. Sharing requests will not be considered or facilitated for members who have withdrawn, cancelled, become inactive or are not in good standing for any reason according to the current Sharing Guidelines. Any eligible expenses incurred and submitted at least 60 days prior to a member’s change in active status may be shared. Expenses incurred or submitted within 60 days of a member’s change in active status will not be eligible for sharing. This information was sent to your verified email address on file and to your verified mailing address 60 days before it became effective on December 1, 2021. Additionally, Pre-Notification is used to determine medical necessity and does not establish eligibility for sharing or guarantee sharing. Unfortunately, because your submission was received after you cancelled your membership, it was processed and deemed ineligible for sharing. The Sharing Guidelines are applicable to all memberships, and therefore we cannot overturn the processing decision for this expense. For more information, please see your: Sharing Guidelines, Page 12, Entry 3.