Provider Portal | Liberty HealthShare

Bill Status

DOS - Date Of Service

Created Date - The date we received the medical expense

Processed Date - The date we processed the medical expense

Charged Amount - The total amount billed

Member Eligibility

Expiration Date - The day the member is no longer effective.

AUA - Annual Unshared Amount.
The amount of medical expense eligible for sharing must exceed an annual accumulative amount assigned for each single, couple or family membership. The annual amount shall be calculated upon each member’s Enrollment Activation Date until his or her next annual renewal date or program level change. All eligible medical expenses that exceed the applicable AUA shall then be subject to the program limits per incident selected by the member.

Wellness Visits
Liberty HealthShare encourages our members to see their Primary Care Physician or Provider yearly to maintain their health and well-being. After the first two (2) months of membership, an annual preventative wellness visit and related lab work for which there are no medical symptoms or diagnosis in advance are eligible for sharing, up to a maximum of $400 of the Fair and Reasonable charges as determined by Liberty HealthShare and not subject to the AUA nor subject to guideline limitations for medical expenses $200 or less.

a. Well baby visits including immunizations are eligible for sharing within the first 13 months after birth and not subject to the AUA or the two-month waiting period.
b. Any new condition based on symptoms discussed during your preventative wellness visit and any additional diagnostics or labs that are ordered to determine treatment are shareable according to Liberty HealthShare Sharing Guidelines and are subject to the AUA.

Screenings

a. The following preventative screenings are not subject to the AUA:: i. Screening pap smears are eligible for sharing once every year.; ii. PSA tests, and Cologuard® are eligible for sharing once every two years up to and including age 49.; iii. PSA tests, and Cologuard® are eligible for sharing once every year for members 50 years of age and older.; iv. Screening mammograms are eligible for sharing once every year for women 40 years of age or older.
b. The following screenings are eligible for sharing and are subject to the AUA:: i. Screening colonoscopies and bone density screenings; ii. Ultrasound/MRI/Thermogram screening conducted in lieu of a screening mammogram; iii. All diagnostic screenings

Sharing Program

Liberty Unite: Up to $1,000,000 (per incident) of fair and reasonable eligible medical expenses are shareable after AUA has been met. There is no co-share.
Liberty Connect: Up to $1,000,000 (per incident) of fair and reasonable eligible medical expenses are shareable after AUA has been met. Member pays a 15% co-share.
Liberty Essential: Up to $600,000 (per incident) of fair and reasonable eligible medical expenses are shareable after AUA has been met. Member pays a 25% co-share.
Liberty Assist: Up to $100,000 (per membership year) of fair and reasonable eligible expenses are shareable after AUA has been met and secondary to Medicare Parts A and B.
Liberty Rise: Up to $50,000 (per membership year) of fair and reasonable eligible medical expenses are shareable after Unshared Amount per Visit has been met.
Liberty Freedom: Up to $300,000 per incident OR per calendar year (whichever comes first) of fair and reasonable eligible medical expenses are shareable after AUA has been met. There is no co-share.

Medical Expenses Eligible for sharing	Unshared Amount Per Visit	Maximum Sharing Limit
Primary Care Physicians	$25	$750/year
Specialist Physicians	$40	$750/year
Urgent Care	$50	$500/year
Hospital Stays*	-	$1250/day
In-/Outpatient Surgeon Fees*	-	$1250/day
Emergency Room	$500	$1000/year
CT Scans	$200	$1250/day
MRI Scans	$200	$1250/day

Wellness Visits and Screenings

Wellness Visits

Liberty HealthShare encourages our members to see their Primary Care Physician or Provider yearly to maintain their health and well-being. After the first two (2) months of membership, an annual preventative wellness visit and related lab work for which there are no medical symptoms or diagnosis in advance are eligible for sharing, up to a maximum of $400 of the Fair and Reasonable charges as determined by Liberty HealthShare and not subject to the AUA nor subject to guideline limitations for medical expenses $200 or less.
- a. Well baby visits including immunizations are eligible for sharing within the first 13 months after birth and not subject to the AUA or the two-month waiting period.
- b. Any new condition based on symptoms discussed during your preventative wellness visit and any additional diagnostics or labs that are ordered to determine treatment are shareable according to Liberty HealthShare Sharing Guidelines and are subject to the AUA.
Screenings

a. The following preventative screenings are not subject to the AUA:

i. Screening pap smears are eligible for sharing once every year.

ii. PSA tests, and Cologuard® are eligible for sharing once every two years up to and including age 49.

iii. PSA tests, and Cologuard® are eligible for sharing once every year for members 50 years of age and older.

iv. Screening mammograms are eligible for sharing once every year for women 40 years of age or older. .

b. The following screenings are eligible for sharing and are subject to the AUA:

i. Screening colonoscopies and bone density screenings

ii. Ultrasound/MRI/Thermogram screening conducted in lieu of a screening mammogram

iii. All diagnostic screenings

Welcome to Liberty HealthShare Provider Portal

Liberty HealthShare members participate in the HST PHCS network. This is driven by our commitment to meet the emerging needs of our members and provide them with all the services of a Value Driven Health Plan including a new optional network of more than 900,000 healthcare providers, greater transparency in making healthcare decisions and a significant reduction in unexpected costs.

You can verify that you participate in the PHCS network at HST-PHCS Provider Search.

If you do not participate in the PHCS network and wish to do so, you can do so at Provider Nomination : Provider.

Liberty HealthShare members may access care through PHCS's Practitioner and Networks at contracted rates. Providers may be reimbursed pursuant to the terms of Liberty HealthShare’s Sharing Guidelines up to Fair and Reasonable Consideration (subject to reference-based pricing). Only physician and ancillary services may be subject to a PPO Network. The Program will only consider an Assignment of Member Shares Received for Eligible Expenses valid under the condition that the Provider accepts the member-to-member sharing received from the Program as consideration in full for the services, supplies and/or treatment rendered, less any required Annual Unshared Amount and/or Co-Share. Prenotification is required for certain services, procedures and diagnostics. Submission to prenotification does not guarantee eligibility or sharing.

Online Services

Eligibility

Eligibility

Check member eligibility online.

Medical Bill Status

Bill Status

Checking Bill Status.

Prenotification

Prenotification

Submit a Prenotification.

Healthsharing

Healthsharing

Working with Healthcare Sharing

Sharing Guidelines

Sharing
Guidelines

PDF 635 kb

Prenotification

Prenotification
Request Form

PDF 183 kb

W9

PDF 183 kb