At CHM, we work to review and share your medical bills as quickly as possible while carefully stewarding your monthly contributions. The CHM process serves and protects you; it’s your money, sent to meet your needs and those of other members. Each of the following steps is vital in that process.
CHM Care Solutions
Many members contact CHM saying they have no family physician, or, having received a physician’s diagnosis, members are unsure about the care they’re receiving. CHM’s research capabilities can help you find a high-quality physician at the best cost. CHM has arrangements with specific providers where, in exchange for a prearranged discount, we pay them directly.
Additionally, some of our CHM Care Solutions offer perks in the form of direct payment to your provider:
- Complete Surgical Care Solution(CSCS): If you receive your surgery through a CSCS provider, CHM makes arrangements—including necessary travel—and then pays the provider directly. All you need to do is receive your surgery and focus on healing.
- Cancer Care Solution (CCS): There are times when you may be able to receive your cancer treatment through a CCS provider; in these cases, CHM pays the provider directly, allowing you to focus your energy on recovering.
Medical bill sharing steps
Whether we send a sharing check for eligible medical expenses to you or pay your provider directly, the way your bills are processed before sharing remains the same.
Each of these steps makes sure everyone’s medical bills are shared according to the CHM Guidelines, which promotes consistency and fairness to all members.
First step: Records
The quickest and easiest way to submit bills and answer CHM’s questions about your medical event is through the CHM Member Portal. Bills and the sharing request packet can also be submitted via fax, or mail. CHM staff sort them by date of receipt, making sure that everything is labeled and categorized correctly.
Second step: Data Entry
Our Data Processors review the medical bills. If the medical bills aren’t fully itemized or we’re missing required information, our Data Processors will submit a request using the Member Portal, or, if you don’t have portal access, through regular mail.
Third step: Authorization
CHM’s authorizers review medical bills for eligibility and categorize them according to the CHM Guidelines. There are times when CHM requests medical records directly from the provider, but, ultimately, members are responsible for making sure CHM receives the necessary medical records within Guidelines-specified time periods.
Fourth step: Member Advocate
If you’ve already secured a discount with your provider, your medical bills move to the fifth step. Otherwise, CHM’s Member Advocate team negotiates discounts, verifies balances, and sees if you qualify for financial assistance.
Fifth step: Member Reimbursement
Finally, our Member Reimbursement team releases eligible funds to you, or in some cases, your provider, in the form of a sharing check.
Each step is to safeguard your money and to use it properly.
Sharing and caring
CHM staff members are praying for you—our members—especially those experiencing medical events.
CHM is a ministry, and our staff members pray with members over the phone, add them to the Prayers Unceasing list included with your monthly statement, or include Scripture with your sharing checks.
Thank you for your heart to serve your brothers and sisters in Christ through your participation and prayer.
Editor’s note: CHM is a health cost-sharing ministry, not an insurance company, medical provider, or health insurance network. Membership is not insurance. Medical bill sharing is voluntary, subject to the CHM Guidelines, not guaranteed, and not contingent upon the use of a specific provider or provider network. Members remain personally responsible for their medical bills. Medical care is provided by independent healthcare professionals. Health information in this publication is educational and does not replace professional or individualized medical advice. CHM Members in Maryland may be subject to a different bill sharing process and should refer to the state-specific legal notices found here.
