We strive to share medical expenses in a timely, accurate manner. To do this, it is crucial for members to submit sharing requests correctly and include all required documentation.

Submitting a Sharing Request

Sharing requests should be submitted through the Member Portal, as soon as possible. Most nonemergency sharing requests, such as surgical procedures, should be submitted prior to the date of service.

Members may contact Zion HealthShare directly during business hours for help with this process.

Contact the Member Care team:

• 888-920-9466
• member@zionhealthshare.org

The Medical Advocacy service is complimentary to all Zion HealthShare members. Our team of experts is here to help members find providers and facilities. We can help members obtain self-pay discounts and pay ahead of time for eligible expenses.

Contact the Medical Advocacy team:

• 888-399-0017
• advocacy@zionhealthshare.org

Required Documentation & Time Limit for Providing Documentation

In order to be eligible for sharing, sharing requests and each itemized bill and statement must be submitted within six months of the date of service. The IUA must also be paid within six months to be considered for sharing. When submitting a sharing request, members should submit any documentation received from their provider. Zion HealthShare may request additional documents that may be required throughout the sharing request process. Document types can include, but are not limited to, receipts, proofs of payment, itemized bills and statements.

Original, itemized bills and statements should be submitted promptly to Zion HealthShare along with the sharing request form for us to process the sharing request as soon as possible.

Please reference all applicable guidelines to determine if there are other document requirements or time limits.

Meeting the IUA

Medical expenses are only shareable after members have met their IUA. Members should provide documentation to Zion HealthShare of all payments that may contribute toward the member’s IUA.

The IUA must be paid within six months of the date of service or bills may become ineligible for sharing. Consideration will be given for situations where the cost of treatment has not exceeded the IUA after six months for certain sharing requests. Members must communicate with their Member Needs team representative about a timeline for IUA payment.

Aging Out at 65

Medical incidents that occur within thirty (30) days of the members scheduled age-out at sixty-five (65), will have up to thirty (30) days after their membership end date to submit a sharing request. All other time limits will remain in effect including:

• itemized bills and statements must be submitted within six (6) months of the date of service, and
• the IUA must be paid within six (6) months of the date of service, or they become ineligible for sharing.

Medical Records Addendums

Medical Records may be requested to assist with the determination of a sharing request. After the requested medical records have been reviewed and a determination is made, medical record addendums will not be considered unless they are combined with an official addendum from the applicable provider. The addendum must be separate and include the following:

• signature from the applicable provider,
• date,
• description of what was changed, and
• reason for change.

Paying at the Time of Service

Zion HealthShare is not insurance, so members should tell their provider they are an uninsured, self-pay patient. That way, members can obtain self-pay discounts on services, which allows us to keep membership contributions low. Members should obtain itemized

bills and receipts to request payment or reimbursement from Zion HealthShare. In some cases, prepayment may be an option.

Contact our Medical Advocacy team before receiving medical treatment for prompt payment at the time of service.

Requesting Discounts

Members have options for sharing prior to, at the time of, or after medical services are rendered. For all purposes, members should present as self-pay patients and communicate costs and discounts as soon as possible to Zion HealthShare.