• If an in-network provider refuses to bill Medi-Share directly after talking to our representatives, you may want to search and locate another provider using the Healthcare Bluebook tool in your Member Center. 
  • If you choose to continue utilizing this provider, please ensure that the provider will give you a HCFA or UB form at the time of service. 
  • Log in to your Medi-Share Member Center.
  • Navigate to the Resources menu and select Member Forms.
  • Locate the online Medical Bill Submission Form.
    
  • Follow the prompts to upload your completed HCFA or UB form and include a copy of the itemized bill.
  •  Once you submit your HCFA or UB form, you’ll receive a confirmation email with case number for your reference. Once processing has been completed, you’ll receive an email directing you to review your EOS available in the Member Center.  
  • If payment is due, you will receive the check as reflected on your EOS and are responsible for paying your provider.

• HCFA and UB are industry-standard healthcare forms that all providers utilize to submit medical services for consideration. 
  • Besides being industry-standard, these forms are important for efficient and accurate processing of medical needs according to our member-voted guidelines. 
  • In most cases, properly completed forms provide Medi-Share what’s needed for initial processing. Additional information like medical records, primary payer information, or supporting documentation may be requested in some situations. 
  • What if my provider won’t give me a HCFA or UB form? You can still submit your bill here, however, without the HCFA or UB details, more information from you will be required and it will take more time to process your request. 

• Please note that when using out-of-network providers, you may incur an additional member responsibility if the Provider does not accept the Medicare allowable rate. Please review the Medi-Share Guidelines, Section V. B. 
• *** If the visit is for a life-threatening medical emergency or there are no in-network providers within 25 miles of your home, a penalty waiver request may be submitted for review  by Medi-Share. 
• When utilizing out-of-network providers who refuse to bill Medi-Share directly, it is important to obtain a HCFA or UB at the time of service. Submit your HCFA or UB here. (link) Once received, you’ll receive a confirmation email with case number for your reference. Once processing has been completed, you’ll receive an email directing you to review your EOS available in the Member Center. 
• If payment is due, you will receive the check as reflected on your EOS and are responsible for paying your provider. 

The Submission process must be completed using this online link. Please do not email your request, or use any other paper form to submit any medical bill or any supporting documentation.  

The following are not necessary to support your request: 

• A notification that you met your AHP 
• Proof of your provider fee payment(s) 
• Proof of other charges noted as your responsibility 
• Submission of ineligible bill 

Please familiarize yourself with the program guidelines. The following examples are not eligible for sharing and should never be submitted for consideration: 

• Chiropractic care that has not been previously approved in-lieu of surgery 
• Routine/preventative services outside of well-child visits up to the age of 6 
• Annual physicals with limited labs for Medi-Share Members on a new program level as of 7/1/20 
• Dental services not related to an accident
• Mental health counseling and psychiatric services not related to an eligible medical event