Guidelines - VI.A Member Payments & VI.B Payment Processing

REDEEM HealthShare processes bills electronically, with payments typically made to the provider within 30-40 days of receiving the member’s bill. Payments to a provider derive from Shares collected by the patient from the REDEEM member community.

A. Member Payments

Members pay a monthly share amount based on age, membership size, and selected Annual Unshareable Amount (AUA). The REDEEM community sends monthly Shares to the patient to pay their medical bills. For quick processing, REDEEM HealthShare prefers that providers submit bills electronically through EDI using the Payer ID on the patient’s Member Card.

B. Payment Processing

REDEEM HealthShare processes most bills within 30 days, with electronic payments sent to the provider, minus any amounts the member will pay directly (AUA or Co-Share). The provider receives an Explanation of Sharing (EOS) detailing the amounts paid from Shares collected by the patient from the REDEEM member community.