Fair Pricing Commitment

Introduction 

This article will help you understand why REDEEM HealthShare shared your bill for less than the charges listed on your bill.

Rising healthcare costs and complex billing can leave members vulnerable to inflated charges. REDEEM HealthShare Ministry addresses this challenge by carefully reviewing each bill for accuracy and applying reference-based pricing (RBP).

Information 

Reference based pricing has the potential for reducing healthcare costs and increasing the transparency of those costs.

For this reason, REDEEM HealthShare reviews each bill submitted to check for and correct any billing errors. The bill is then cross-checked against both our market-based and RBP research to confirm your bill is a fair and reasonable price for the care you received. This reduces overcharges from inflated healthcare costs and ensures wise spending of your Shares.

If research reveals that your bill is beyond a fair and reasonable price, then the ministry will re-price the bill and that is the amount the REDEEM® HealthShare community sends to the provider.

EXAMPLE: Recently, you saw a doctor and submitted your bill for $850. Using a review program, REDEEM HealthShare finds that a fair and reasonable price for the service is $275. REDEEM HealthShare will then send your provider $275. In most cases, the provider accepts the initial payment from the ministry.

If you have already paid your co-share amount and receive a bill from your provider requesting additional payment, see Determining if You Have a Balance Bill. Once you have submitted your balance bill, REDEEM HealthShare works directly with the provider to settle the account.

As a member of REDEEM HealthShare, reading and understanding the Sharing Guidelines is important.