Submitting a Medical Need
One of the main questions new Solidarity Members ask is, “How do I submit my medical Bill for sharing?” Today we’ll discuss what to do when you receive a bill after your appointment or procedure.
Submitting a Medical Need is the most crucial part of your role as a Solidarity HealthShare Member. Proper need submission contributes to a timely review of a Medical Need and ensures fair and reasonable pricing from your Provider. Completing a needs review allows our team to pay your Provider directly or reimburse you personally if you chose to pay your Provider upfront.
The Need Submission Process
When you see a Provider, have an emergent medical event, or even a hospital stay, there are a couple of different ways in which the Provider will bill you for the service:
- Your Provider will electronically submit the bill to Solidarity on your behalf using the information on the back of your Member Card.
- You receive a paper bill at the time of service or later in the mail.
- If your Provider doesn’t work with you on option 1 or 2, you may be required to pay upfront at the time of your appointment – also known as cash pay.
Important Note: While upfront cash payment may seem like the best financial course of action, we encourage you to have your Provider submit your need to us directly. Direct submissions allow us to work directly and efficiently with your Provider to ensure fair and just pricing. If they would rather you handle the Medical Need, request an Itemized bill and submit it through your Member Care Portal.
Once we have everything needed to process your bill, your Medical Need will be shared into by other Members of the Solidarity community. It’s that easy. After processing, Solidarity will send a payment for the need, and you will receive a finalized Explanation of Sharing (or EOS). Your Explanation of Sharing will break down the Medical Need amount, any repricing on the bill, the amount shared by Solidarity Members, and the amount leftover. If you still have an Annual Unshared Amount responsibility, you may be responsible for paying the Provider.
For more information on submitting a complete/itemized Medical Need as a Member:
- Knowledge Center: What is a “need”?
- Knowledge Center: What information do I need to include when I submit a need?
- Member Care Portal: Medical Bills section > Submit a Medical Need
Note: We know the billing process can seem foreign to you or your Provider. We are happy to proactively discuss your Medical Need submission on a case-by-case basis during the Pre-Notification process.