As a CHM member, you’re not bound to any provider network. Instead, as long as the expenses are eligible for sharing according to the CHM Guidelines, you have flexibility in choosing which provider you want to trust with your care.
This is a fantastic advantage—but it does mean that sometimes your provider won’t know about CHM. What should you do then?
Here are five tips to guide you through this interaction.
Your care is handled by you.
As you’re talking with your provider, it’s important to emphasize medical decisions are handled by you and your provider. They don’t need to get approval or permission from CHM for different treatments.
Explain that you’re a self-pay patient.
This means you need itemized bills sent directly to you, and that you would like self-pay discounts. Most doctor’s offices and hospitals already have pre-established discounts for self-pay patients that will be easily applied to your bill.
Remember, an itemized bill contains: 1) the patient’s name; 2) the date of service; 3) the place of service; 4) the procedural (CPT) codes (or description of services rendered); and 5) an itemized list of charges.
Assure your provider of payment.
While you are a self-pay patient, you have your fellow CHM members to help you carry the burden of health cost sharing! You can assure your providers that they will get paid in a timely fashion. If needed, set up a payment plan with them; usually even small payments will do. When you receive CHM’s check, you can reimburse yourself for your payments and pay your provider.
Know that CHM is here to help.
We have resources online written specifically for interacting with providers to help them understand who CHM is, what we do, and how we work. If you’re having difficulties with a discount or have questions about interacting with your providers, our Member Advocate and Provider Relations teams are standing by to help.
Pay your providers quickly by utilizing the Member Portal.
Submitting your Sharing Request Packet on the secure Member Portal is the most secure and easiest way to submit your medical bills. This helps process your reimbursement more quickly to pay your providers.
