8. Glossary of Terms
Adjusted Amount — The discounted or repriced amount of a medical bill.
Annual Unshareable Amount (AUA) — In a sharing ministry, you are always responsible for your own medical expenses. The AUA is the dollar amount of eligible Needs selected by you for your membership that are not shareable during a 12-month period in addition to any Co-Shares and prorations. The AUA 12-month period begins on the effective date of your membership and resets annually on your Membership Anniversary Date.
Appeal Panel — A panel of 7 to 13 REDEEM HealthShare members who are responsible for reviewing member appeals and making appeal decisions.
Available Balance — The total sum that is available in your Share Wallet for sharing a new eligible medical bill. It is the Total Balance minus the Pending Balance minus the Restricted Balance.
Charge Amount — The gross amount billed by the medical provider.
Cost of Medical Care — The provider’s cost as determined through Center for Medicare and Medicaid Services (CMS) cost reports, acquisition costs based on invoices or statements from the Provider, industry-standard cost-to-charge ratios, a drug’s National Average Drug Acquisition Cost calculated by CMS, a drug's Average Acquisition Cost (AAC) for the state in which the facility resides, a drug’s Predictive Acquisition Cost calculated by Glass Box Analytics, or comparable cost documentation for products or services as determined by REDEEM HealthShare in its reasonable discretion.
Deposit — A function that enables you (if you are the primary member) to initiate an on-demand EFT from an external bank account or credit card to transfer the Total Amount Due specified in your monthly Funding Notice to your membership’s Share Wallet.
Effective Date — The first day of the month that the membership’s current membership year begins. This date might be different from the Member Start Date if the membership has switched some elements of the membership.
Eligible for Sharing — Any testing, treatment, procedure, or service that meets the criteria for sharing as established in the Guidelines, including the Unshareable Amount.
Eligible Medical Bill — An incurred medical bill that meets the criteria for sharing as established in the Guidelines. The shareable amount of an eligible Need might be reduced by discounts, fees, or other sources of payment.
Explanation of Sharing (EOS) — A notice sent detailing the eligibility status of a bill, any discounted amounts, what portion of the remaining charge amount has been shared by REDEEM members, and any remaining amount not shared that you must pay.
External Account — An existing bank account linked to your (primary member) Share Wallet and used to transfer via EFT the Total Amount Due into your Share Wallet each month.
Funding Notice — The notification you receive that details the Total Amount Due for the month.
Illegal Drugs — Any controlled substance which has not been legally prescribed or dispensed, or a prescription drug which is not used in the way it was prescribed.
Know Your Customer (KYC) — An automated query to ensure that an individual is eligible to open an account at a financial institution. This is a process required by US banking regulations.
Member — Any member of REDEEM HealthShare Ministry, including each family member participating in a member household for REDEEM Essential or REDEEM Enhanced and any individual who participates in REDEEM SeniorSaver.
Member Start Date — The date your participation in REDEEM HealthShare begins. REDEEM HealthShare will now consider your Medical bills incurred on or after this date for sharing among the community of members.
Membership — The related family member, residing in a household, participating in REDEEM HealthShare Ministry through the same membership. Membership might also be referred to as a “household membership.”
Membership Anniversary Date — The anniversary date of your most recent Effective Date, if any, otherwise it is the anniversary of the beginning date of your household membership in REDEEM HealthShare.
Monthly Share Deposit Amount — The sum of the Share Portion and Required Miscellaneous Portions published in the Funding Notice.
Need — The spiritual, emotional, physical, and financial needs related to a medical condition or event. A Need includes all bills that REDEEM HealthShare determines are related to the same condition, progression of a condition, or set of symptoms. This includes separate treatments or separate episodes of symptoms. Note: In this document, Need is capitalized when referring to this glossary-defined concept. Lowercase need refers to the general English word.
Need Start Date — The date of service on the first bill received for the eligible Need.
Past Due Date — The day of the month that a Total Amount Due becomes past due.
Past Due Reminders — Notifications sent to delinquent memberships, reminding them that their Share Payment is past due.
Payment Reminders — Funding Notice reminders sent to members indicating that the Total Amount has not yet been paid.
Pending Balance — The sum of EFTs that have been initiated but have not yet been posted to the member’s Share Wallet.
Permitted Sharing Levels — Charges for medically necessary care, for the care and treatment of illness or injury, but only to the extent that the fees charged are within all applicable limitations and restrictions established by the REDEEM HealthShare Sharing Guidelines.
Pledge — A voluntary, non-legally binding commitment by a member to make their monthly Share Amount available for sharing with other members. Pledged amounts reflect the members’ intent to participate in the REDEEM sharing community and are normally published over time through the sharing process. A pledge is not a donation to REDEEM HealthShare and is not designed to function as a personal savings or refundable account.
Pre-Existing — Conditions in which known signs, symptoms, testing, treatment, diagnosis, or use of medication occurred within 36 months prior to Member Start Date. REDEEM HealthShare considers routine or maintenance medications as treatment.
Previous Balance — The sum of any past due, unpaid amounts published in the Funding Notice.
Primary Member — An adult member who is the main contact for the household membership and Share Wallet owner.
Published Amount — The portion of the adjusted amount that is eligible for sharing and has been matched and published to your membership for sharing.
Received Date — The date that REDEEM HealthShare receives the medical bill and begins processing the bill for eligibility.
Required Miscellaneous Portion — An amount set by REDEEM HealthShare to fund certain activities, such as its administrative and program expenses.
Restricted Balance — The sum of funds that have been credited to your Share Wallet for the purpose of paying eligible medical bills. These funds have been designated for paying a particular medical bill; they are considered “restricted” because you may not divert these funds and use them for another purpose.
Service Date — The date that you (patient) received services from the medical provider.
Service Fee — This includes fees for administrative services and program services.
Share Wallet — Your member-controlled account at America’s Christian Credit Union that is linked to your external account.
Share Due Date — The day of the month by that the Total Amount Due is due and will be automatically transferred via EFT in full.
Share Notice — The notification that your share is ready to send to another member.
Share Payment (funding) — Transferring funds (Total Amount due) from a member’s external account to their Share Wallet via electronic funds transfer (EFT).
Share Portion — The portion of the monthly share amount that is collected and used specifically for member-to-member sharing of eligible Needs.
Shared Amount — The published amount that has been shared and collected in your Share Wallet.
Sharing (member-to-member transfers) — Moving funds from a sending member’s Share Wallet to a receiving member’s Virtual Bill Account.
Total Balance — The sum of the Pending Balance, Restricted Balance, and Available Balance in a member’s Share Wallet.
Total Amount Due — The sum of the Monthly Share Contribution Amount (Share Portion and Required Miscellaneous Portion), any Optional Portions (manually configured by the member), Service Fee, and any past due amount (Previous Balance).
Unshareable Amount — The dollar amount you pay toward your eligible medical bills before REDEEM HealthShare publishes your eligible medical bills for sharing with other members.
Virtual Bill Accounts — Accounts at America’s Christian Credit Union created expressly for the sharing of eligible medical bills and subsequent payment to the healthcare provider.