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PHCS negotiates discounts, an average adjustment of 30–35% by staying in-network.
Your Provider Fee of or 5 is also deducted from the total bill.
If you go out of network, it can get a little more complicated with the doctor billing you, you going to Medi-Share to see what they will discount, you sending the payment directly to the doctor’s office.
So bottom line – just stay in network and you’re golden.
(Note: Members may select any provider of their choosing, including out-of-network providers, but in doing so may not benefit from discounting of medical bills as with an in-network provider.) Show your Medi-Share ID Card to the provider, and pay your provider fee— initial charge for doctor visits, 5 for an Emergency Room visit.
Here is how they explain it: “When a medical event occurs, you simply select a network provider from the Private Healthcare Systems (PHCS) PPO network, which offers 700,000 providers nationwide!
CCM processes payment from the member’s account.” From my experience using them, this sounds more confusing than it actually is.
They do all this behind the scenes, so as a member I am not involved in any of that process.
After subtracting for overhead and administrative expenses, the rest goes to pay claims.” The Medi-Share program is flexible with multiple choices of program levels, benefits, and of course out-of-pocket expense.
You are given the option of choosing your own doctors and hospital, but there are discounts available for using networked professionals.
She explained that in the last 24 years every need has been covered (shared or discounted). For example, she told me a story of a member who was in a bad car accident requiring lots of medical work, but since the person was intoxicated when they got into the accident, the expense was not covered by Medi-Share.