The Self-Pay Patient book – corrections, clarifications, & comments, Part 1 of ?

One of the problems with writing and publishing a book is that, unlike a blog, you can’t really go back and make corrections or clarify something, or add something that you realize really should have been included after the book has already gone to press. You can in later editions of course, but otherwise whatever you put in the book is going to stay in the book for anybody who purchased it.

By and large the reception for my book, The Self-Pay Patient: Affordable Healthcare Choices in the Age of Obamacare has been pretty positive. The reviewers on Amazon seem to like it (4.9 stars out of 5), and the e-mails I’ve gotten have all been very complimentary as well. And one of my favorite bloggers, The Frugal Nurse, is out this morning with a great writeup of The Self-Pay Patient book as well.

That said, I’ve had a few people suggest that something wasn’t quite as clear as it could or should have been, or gave the wrong impression, or that something was left out. So I thought I’d use the blog to try to correct any errors or clarify anything that might have been misleading, or otherwise address any issues that have been brought to my attention.

The one I wanted to address today is a pretty big mistake on my part, and it has to do with healthcare sharing ministries and negotiating medical bills. As I’ve pointed out in the past, one of the major challenges to being a self-pay patient is that many hospitals will try to hit you with outrageous ‘chargemaster’ bills that dramatically inflate the price of care well beyond what an insurer would pay. 

One way of dealing with these inflated prices is to use a medical bill negotiator, who will work with the hospital billing department to reduce you bill to a more appropriate level, usually close to what insurers pay. In cases of economic hardship, they can even get the bill reduced below that or written off entirely as charity care.

Members of healthcare sharing ministries often face these ‘chargemaster’ rates as well. In The Self-Pay Patient on page 68 when talking about medical bill negotiation I wrote the following:

…if you are a member of Christian healthcare ministry, they offer members assistance in negotiating reduced medical bills.

Three errors here. One, of course, is the matter of capitalization – it should read ‘Christian Healthcare Ministries.’ Second, it’s ‘Ministries’ plural, not ‘Ministry’ singular.

But the real problem is – Christian Healthcare Ministries isn’t the only sharing ministry that offers assistance in negotiating medical bills.


Not sure how this one slipped through, but for the record, all of the ministries offer some way of dealing with hospital bills that might otherwise force their members to pay the inflated ‘chargemaster’ rates.

Samaritan Ministries, for example, has partnered with a bill negotiation service that will work to reduce medical bills on behalf of members. It’s not explained on their web site, at least that I could easily find, but members of Samaritan who join The Health Co-Op are able to have them negotiate medical bills on their behalf, among many other services that The Health Co-Op offers. I believe that members of Samaritan who aren’t members of The Health Co-Op also benefit from free medical bill negotiation services as well.

Christian Healthcare Ministries has an in-house medical bill negotiation service. Here’s how they describe it on their web site:

Christian Healthcare Ministries’ medical bill Reductions department helps members obtain millions of dollars in medical bill reductions every year. This office—a valuable resource for CHM members — counsels on the best methods by which to obtain reductions and works with members and health care providers to qualify members for assistance programs. We have worked with more than 40,000 health care providers.

Christian Care Ministry, which more people might recognize under the name Medishare, has a little different model. They actually have a network of providers through a company called MultiPlan with negotiated rates, just like insurance companies do. They  will negotiate bills in the event someone goes to a provider that isn’t in-network. Altrua also uses Multiplan.

Liberty Healthshare is a little vague on the details, and the language appears to have changed from the last time I looked, but their web site does state that the “Doctor sends bills electronically to discount network” and says that they “have a team of professionals that will advocate for you throughout your medical incident to manage your care efficiently.”

So it looks like both Christian Healthcare Ministries and Samaritan Ministries use medical bill negotiation services to help prevent their members from getting hit with inflated ‘chargemaster’ rates, while Christian Care Ministry and Altrua have both connected with a more traditional, insurance-like network of providers. I’ll try to update what exactly it is that Liberty does to provide similar protections for their members.

I hope this clears the matter up, and as always I’d welcome any feedback people may have!

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4 Responses to The Self-Pay Patient book – corrections, clarifications, & comments, Part 1 of ?

  1. Sue Hokana says:

    Interested in whether you have found out the exact model for Liberty Healthshare yet. We live in a rural area where it is unlikely there will be local providers available under Christian Care Ministries or Altrua plans (although haven’t specifically checked provider listings). Therefore, am more interested in becoming a member of a plan that doesn’t restrict members to specific providers and offers a separate bill negotiation service — that way I don’t have to drive 50 miles to get to a provider/hospital. Thanks, Sue

    • says:

      Planning on getting it out in a blog post in a few days, but I did talk with Liberty and they tell me that they simply pay the Medicare rates, and that it in almost all cases is acceptable to the provider. In the few cases in which it isn’t, they have someone who calls and negotiates. So it looks like it would fit with what you’re looking for, as would either Samaritan or Christian Healthcare Ministries.

  2. John says:

    I’ve been researching various HCSMs for a few months as a replacement for the Golden Rule PPO I have now. I love the plan I have except for the rapidly escalating cost. I think the Christian Health Ministries Silver plan fits my situation best except that there is no PPO or other discount plan tied to it. CHM will cover the big stuff but when I go in for lab work twice per year, the self-pay prices are 10 to 20 times what the PPO price is. I’d feel much more comfortable if I could buy into a PPO directly as an individual consumer. Do you know if any company will sell access to their PPO network to an individual?

    • says:

      There are medical discount cards out there that essentially rent the networks of insurers, although this is an area to very carefully research the company offering them, as there are lots of scams and frauds related to medical discount cards, mostly regarding their marketing (people are led to believe they are insurance). As for lab work and other routine expenses, check out the market page here and you’ll see discount lab companies that will give you real prices, not inflated chargemasters.

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