Although paying for your medical expenses up front and submitting them for sharing (reimbursement) is an option, it can make the billing process longer, more complicated, and more expensive. We recommend having your provider bill us directly whenever possible.
Member Submitted Bills:
When a Member pays their bill as a self-pay patient and submits it for reimbursement, there are a few added steps. First, you need to make sure that you get an itemized bill for your service, which includes the procedure (CPT) code and diagnosis (ICD-10) code for each item, along with some other critical information (see the full list here). If the bill that the provider gives you doesn’t include all of that information, make sure to ask them to send you an amended bill which does. Once all of this information is received, it is then entered manually and validated to make sure that all the information we need is there. If the submitted bill is missing some of the necessary information, that will delay the processing for that bill until all the information is received.
Provider Submitted Bills:
When a provider submits a bill to us directly, all of the necessary information is already included on the forms that they fill out and submit. This speeds our processing time considerably, as that information can be entered into our system automatically, and gets processed without needing to be reviewed on a manual basis. We are also able to negotiate pricing with providers when they bill directly, and average saving about 60% off billed charges. We work very hard to maximize the sharing power of our community so that we can share all of the medical expenses that our Members need. This is why it is so important to advocate for your provider to bill Solidarity directly. For some helpful walkthroughs on how to talk to providers about direct billing at the time of service, Click Here.