One Share, One Voice | OneShare Health Blog

You Have the Freedom to Choose Any Provider | OneShare Health Blog

Written by OneShare Health | 5:00 AM on May 15, 2022

How to Stretch Your Healthcare Dollar with OneShare's Freedom of Choice 

Traditionally, consumers are in the habit of seeking medical services through a defined Provider Network – if a doctor or hospital isn't on the list, benefits are reduced. That's not the case with the new OneShare Health Programs. So go where you'd like, your Program Features will not be affected. 

As a OneShare Health Member, we are giving you the freedom to choose a healthcare Provider; to go to any hospital or Facility of your choosing. Why? To lower Out-of-Pocket expenses for your care and stretch your healthcare dollars.

Save up to 50% or more on your family's health care! Input your ZIP Code below for a free OneShare Health quote!

To bring you this no-restriction freedom of choice, we facilitate sharing at a Fair and Reasonable Amount for Eligible Inpatient, Outpatient, Hospital, Surgery Center, or Clinical Lab Facility care. 

 

So, what is “Fair and Reasonable?” 

Healthcare prices are going up, which affects Member Out-of-Pocket costs and the amounts they contribute to share in each other’s expenses. OneShare exists not just to facilitate the sharing of these expenses but to partner with and advocate for our Members throughout their healthcare journey. To help keep Member costs down, we are utilizing a Fair and Reasonable Sharing methodology. 

According to your Member Guidelines, the Fair and Reasonable Amount is the amount approved for sharing for certain Eligible Expenses. The Fair and Reasonable Amount is calculated as a percentage of an objective benchmark value for the services provided.

Fair and Reasonable Sharing is OneShare Health’s model that facilitates sharing at a fair amount when compared to services performed. We start with approving an amount based upon a percentage above the Provider’s Medicare rate. If a Provider does not accept that amount, we will advocate on your behalf with the Provider to significantly reduce their charges, when appropriate.

We use Fair and Reasonable Sharing for the following: services performed in an Inpatient or Outpatient Hospital setting, Surgery Centers, Clinical Labs, and services from doctors not listed in the My Choice Provider Locator. OneShare stands ready to advocate for Members to help lower their costs and create an efficient and enjoyable Member experience. 

Read more about Fair and Reasonable Sharing and OneShare Health’s Freedom of Choice on our Knowledge Base

 

How Do I Choose Where I Want to Receive Care? 

To maximize your Program, receive care from whoever you want without restriction, and stretch your healthcare dollar further, our Members can follow this simple Freedom of Choice Guide! 

Step 1: For the Common Cold, Allergies, and Much More: Smart Virtual Care 

Smart Virtual Care visits are always 100% shared at OneShare Health, which is at no additional cost to you. Virtual Visits on average with Clever Health™, our Smart Virtual Care provider, take about 16 minutes from start to finish. This means you'll be saving time and money! 

Through the Clever Health™ App, you'll experience greater convenience, faster visit times, more accurate diagnoses, and additional Prescription Discounts. It's your go-to for common ailments such as: 

  • Allergies 
  • Cold & Flu 
  • Digestive conditions 
  • Ear Infection 
  • Fever 
  • Insect Bites 
  • Joint Aches and Pains 
  • Rashes 
  • Sinus Infections 
  • Skin Inflammation 
  • Urinary Tract Infections 
  • Asthma 

Just download the Clever Health App now to get started! 

Step 2: Find Your Doctor 

We know how important it is to see the doctors you trust. Therefore, our Members have access to the easy-to-use My Choice Provider Locator, which lists the Providers who have an existing relationship with OneShare or one of our partners and whose bills are likely to be processed more quickly and efficiently. 

We accept any accommodating Provider and will work with them behind the scenes to ensure you receive a fair price for the services performed. However, OneShare Members are not limited to those doctors listed in the My Choice Provider Locator. So if you don't find the doctor you're looking for, our team is ready to help! 

Here's how to find your doctor: 

  • Your OneShare Health Program uses the My Choice Provider Locator for doctor services. To search for a doctor or Provider, go to MyChoice.OneShareHealth.com 
  • Not seeing your doctor in the My Choice Provider Locator? Not a problem! See your selected Provider, anyway. Providers will call OneShare Health to verify your Membership, and our trained team of Coordinators will take care of the rest.  

 

Step 3: Find a Facility Such as a Hospital, Surgery Center, and More 

Have you ever been worried that the Facility you visit for a procedure is considered Out-of-Network? Well, worry no more! At OneShare, we provide cost sharing to any accommodating Inpatient, Outpatient, Hospital, Surgery Center, or Clinical Lab Facility for Eligible services under your chosen Program. 

Here's what you need to do: 

  • If you need to schedule services at an Inpatient or Outpatient Hospital setting, Surgery, or Clinical Lab, call OneShare Health at least 10 days before your visit so we can help you find a Facility. 
  • OneShare Health will process Eligible services at a Fair and Reasonable Amount. 
  • If, for any reason, you receive a balance bill from a Provider, contact OneShare Health immediately via email at Correspondence@OneShareHealth.com and be sure to attach the bill from your Provider in your email. OneShare will work with your Provider and advocate on your behalf to settle your balance bill. 

Read more about Fair and Reasonable Pricing and OneShare Health’s Freedom of Choice on our Knowledge Base!  

 

How Does Our Fair and Reasonable Sharing Work? 

Here at OneShare Health, we’re committed to working to ensure you receive a fair deal on how much you pay for your medical care. Our first step in processing Eligible Sharing Requests is to compare your bill against an established, objective benchmark. In our case, as stated above, that’s the percentage above Medicare allowable. 

OneShare will then facilitate sharing at an amount above that rate based on where and by whom the services were rendered. By using this established benchmark, we are able to help save Members money. 

It is a lot like shopping at the grocery store. When you look at two of the same items, you may notice that one has a higher price tag but there is no difference between the two items other than the price. The same is true for healthcare. When the care and quality are the same for a set procedure, it can be confusing when you see differences in price. That’s why we work for you to analyze how much you’re being charged for your care. 

In most cases, the Provider will accept this initial sharing amount as payment-in-full. However, it's important to note that no one can guarantee this will happen 100% of the time. If a Provider insists on charging you more than the initial sharing amount, and sends you another bill, we’ve got your back! OneShare Health will initiate the second step in our Fair and Reasonable Sharing process: negotiation. OneShare Health's trained team of Coordinators will contact your Provider and work toward a resolution that doesn’t leave you holding the bag. 

Read more about balance billing and how OneShare Health advocates to lower your bills here

Read more about Fair and Reasonable Pricing and OneShare Health’s Freedom of Choice on our Knowledge Base!  

If you need assistance or want more information on Fair and Reasonable Sharing, please contact Member Support at (855) 699-1274, Monday through Friday, 8 am — 6 pm CST, or by email at MemberSupport@OneShareHealth.com

Save up to 50% or more on health care! 

If you don't want to go the Obamacare route, and also want to save money on your care, check out our Health Care Sharing Ministry that's exempt from the ACA. OneShare Health is an alternative to traditional insurance coverage, we are a Health Care Sharing Ministry that could start saving you thousands per year on your healthcare!

Click below to learn more or get your free OneShare Health quote today.

"Do nothing out of selfish ambition or vain conceit. Rather, in humility value others above yourselves, not looking to your own interests but each of you to the interests of the others." 

Philippians 2:3-4 (NIV)