Zion Health advocates for our community to have the freedom to choose the provider they want. This has always been true, but prior to this year, some of our memberships included access to the PHCS Network. It was a common belief that members were limited to providers in the network. Last year, we decided to clarify our message and announce that we would no longer participate in the PHCS network. This change has been a relief to many and confused others.
We would like to clarify our decision to end participation in the network and talk about how it affects our members.
Reasons Not to Participate in the PHCS Network
Let’s start with why the decision was made to no longer participate in PHCS network.
Simplicity. Many Zion Health community members and providers were confused by the PHCS network. In addition, some of our memberships included the network while others did not.
Savings. Self-pay discounts are much better than the PHCS network contracted rates, especially on large medical bills. The Zion Health community saves money by using the self-pay model in both medical bill rates and costs to participate in the PHCS network.
Access. Many providers did not want to accept the PHCS network rates for members of any HealthShare due to prior experience with other medical cost communities.
Member Experience. We strive to make the member experience simple and efficient. As we have grown, the PHCS network slowed down the processing of medical bills and navigating healthcare became more difficult for our members.
Provider Experience. We want to make sure the providers working with the Zion Health membership are not at a disadvantage. Network participation causes extra administrative work for providers and made them less willing to work with our community members.
Compliance. Having the PHCS network blurs some of the lines that are clear with what a medical cost share community is and how we are different from insurance.
New Medical Need Request Process
Working with Zion Health is only getting better as we continue to develop technology and processes while providing that individualized touch that we all want.
- Skip the line & get medical care. Utilize the Medical Advocacy team for easy access to medical care and a streamlined sharing process. The Medical Advocacy team can help you find a provider, schedule care, and coordinate sharing for sharable preventive care, surgeries, and other medical services.
- Ask for self-pay discounts. When working with providers, present yourself as a self-pay patient. This helps the community get the best rates and makes billing easier for the providers. Upon approval of a sharable need, Zion Health will issue you a single-use credit card to process payments with your provider, making sharing easy.
New Advantages of Zion Health Membership
The Zion Health community has resolved all the concerns that we had with the PHCS network. Members only have a net gain with this change and are already starting to see new benefits.
Simplicity. Members now all have the same method for sharing medical expenses with the Zion Health community.
Savings. Now that we are no longer participating in the PHCS network, the Zion Health community has already started seeing significant savings.
Clarity. Members can clearly work with any medical provider.
Faster Processing. Zion Health started the year with a growing backlog of medical need requests to process. Now we are getting back to our commitment to our membership by processing medical expenses quickly.