Follow this quick guide to help you get started with your membership.
01. Read the Membership Guidelines
If you have not received your copy of the latest Membership Guidelines book, you can download the PDF version.
We encourage members to read the entire book, however, it is important to know and understand the “Eligible Needs” and “Ineligible Needs” sections as it is the member’s responsibility to find out if their medical needs are eligible for sharing.
02. Setup an Appointment or Services
Because we are NOT insurance, we ask that our members do the following to ensure a seamless experience when dealing with providers.
- When calling your provider, let them know you are a member of Altrua HealthShare, a Recognized Health Care Sharing Ministry, who has access to the PHCS practitioner only network and you would like to schedule an appointment.
- If the provider needs additional information, request that they call us at 1.888.244.3839, and follow the prompts for eligibility.
- When you arrive at your appointment, present your Membership Card. It has the necessary information to process your medical needs.
- The provider should call for pre-authorization, although, it is still the members responsibility to ensure they have pre-authorization before receiving services. Certain procedures, tests, and services require pre-authorization to be considered eligible. Keep in mind that authorization alone does not make a need eligible. Refer to the Membership Guidelines to understand pre-authorization and sharing limits.
If the provider asks you to pay in full up front, be sure to decline.*
We must receive notification within 96 hours of an emergency room visit for the need to be eligible.
03. Process a Medical Need
After you have received services, the provider will typically send your medical need to us within 30-60 days. If the medical need is not received from the provider, we advise that you send us the paper work.
We allow medical needs to be received no later than 6 months of the service date.
- In some cases, medical records may be requested to review the eligibility of your need. Medical records are typically sent by the provider, but assistance by the member to expedite the process is welcome.
- Certain injuries and illnesses require the member to submit the Needs Processing Form.
- We ask that members allow 30-45 days to process medical needs once they have been received and include all required documents.
04. Working With the Provider
Members have access to our Resolutions Department which can negotiate on the member’s behalf when medical needs are catastrophic or the member is balance billed.
- Our Resolutions team will reach out to the member to ensure all necessary paperwork and information is up to date.
- Our Resolutions team will determine the best settlement option for the member’s medical need on behalf of the membership.
- Our Resolutions team will contact the provider to obtain the deepest discount possible on the specified medical need.
When the medical need is resolved, an update will be issued to both the member and provider detailing discounts, member responsibility, and shared amounts.