Wellness Visits and Screenings
  • Wellness

    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 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 a preventative wellness visit and any additional diagnostics or labs that are ordered to determine treatment may be shareable according to 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. Screening mammograms, PSA tests, and Cologuard® are eligible for sharing once every two years up to and including age 49.
    iii. Screening mammograms, PSA tests, and Cologuard® are eligible for sharing once every year for members 50 years of age and 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
    c. Liberty Select Program Exception: Preventative screenings are eligible for sharing and included in the $400 maximum per membership year for wellness visit, related lab work and screenings and not subject to the AUA.

Welcome to Liberty HealthShare Provider Portal

Effective June 1, 2023, Liberty HealthShare members will be participating in the HST PHCS network. This transition 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.

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 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.

Downloadable Resources

Sharing Guidelines (PDF)

PDF 635 kb

Prenotification Request Form (PDF)

PDF 183 kb

W9 (PDF)

PDF 183 kb