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Provider Help: Preferred Provider Organization Questions

WeShare® by UHSM is a health share, an affordable alternative to traditional health insurance.

We are equally committed to our PHCS® PPO Network. Our goal is to be the best healthcare sharing program on the planet and to bring our providers an efficient, streamlined experience every time.  

Obtain healthcare sharing preauthorization

We strive to help our members understand their program benefits and make educated decisions avoiding surprise bills after care is obtained. To achieve this goal, we require preauthorization for all medical services, except wellness and preventative, immunizations, urgent care, emergencies, DocDay and CVS MinuteClinic services. 

To request and obtain preauthorization, please follow the steps below:  

1

Click here to download and complete this PDF form  

2

Complete the preauth form and attach any necessary documentation for the procedure 

3

Send the completed form plus any additional documentation to Fax number: (888) 317-9602 

Please note that WeShare® by UHSM has a standard turnaround time of five (5) business days on all prior authorization requests. If you require any help with the form, need status of your request, or are unable to determine if a procedure requires pre-authorization please contact us at (757) 210-3435.   

Prior Authorizations are for professional and institutional services only. All oral medication requests must go through members’ pharmacy benefits. By submitting this prior authorization, you are agreeing to work with WeShare® by UHSM on in-network pricing. 

Download pre-auth form

Contact us

Phone

+1 800-900-8476
+1 757-210-3435

Email

[email protected]

Main Office

Dominion Tower
999 Waterside, Suite 2600
Norfolk, VA 23510

Hours of Operation

Monday – Friday
10am – 8pm E.T.

Preferred Providers FAQ

At WeShare® by UHSM we work hard to make sure our members and providers have simple and fast medical bill processing. Out members will have preset, per-visit consult fees that operate similar to your insurance patient’s co-pay. We promptly process your remaining network-contracted fees. Here are some frequently asked questions and answers regarding care within PHCS® PPO Network. 

WeShare® by UHSM currently uses Claimsnet for the clearinghouse and is in the system as “UHSM – Unite Health Share Ministries™” with NAIC# 07689, claim type HCFA.  While all the trading partners have been notified, many won’t set up the payer ID until a provider requests it. To request UHSM setup, as the provider all you have to do is: 

  1. Open a customer service ticket at your clearinghouse — Request the setup of payer ID , with routing to SSI Claimsnet.
  2. Send that service ticket number along with the clearinghouse name to Claimsnet helpdesk to complete the integration [email protected].    

You will need to be contracted with our preferred network PHCS PPO. Please click here (expired MultiPlan Web Page) to join PHCS. WeShare® by UHSM is committed to processing all medical bills promptly and efficiently, and to making your job as a provider as seamless as possible. 

Electronic Submission :
PAYOR EDI #07689

Mail paper HCFAs or UBs to:  

UHSM WeShare 
P.O. Box 247 
Alpharetta, GA 30009

Just like any other payer within the PHCS PPO Network, your medical service fees will be paid according to your contracted rate.   

All WeShare® by UHSM programs include benefits in which members pay you (the provider) a consult fee per office visit, unless the appointment is a routine annual physical or preventive care, in which case the per visit fee to members is $0.   

If you are wondering how much to charge a WeShare® by UHSM member for a particular visit please reference the front of the PHCS Weshare member ID card or the specific Program Details. The per visit consult fee each WeShare® member pays varies per program, but operates similarly to co-pay by aligning with the type of medical consult: primary doctor, specialist, urgent care and emergency room visits. If you have additional questions please contact us.  

For questions about the eligibility of medical services that may be recommended following an appointment, please submit a UHSM preauthorization form here or contact us at (757) 210-3435. 

Preauths take 3 – 5 business days maximum.

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© 2023 Unite Health Share Ministries™ and WeShare®

WeShare® is not a reimbursement program. WeShare® is not an insurance company nor is the membership offered through an insurance company. WeShare® membership is offered and administered by Unite Health Share Ministries™ (UHSM), a nonprofit, religious healthcare sharing ministry that facilitates member-to-member sharing of medical expenses. WeShare® is connected through partnerships to provide resources, community, and healthcare for all WeShare® members. WeShare® members have access to pre-negotiated rates for medical services through vast networks, including the PHCS® PPO, CVS Caremark™, BetterHelp, DocDay and CVS MinuteClinic™ networks. Members should never have to pay cash up-front for services in-network, with the only payment incurred at the time of service being the per member, per visit, consultation fee, as outlined in the Membership Guidelines. All Sharing Members are responsible for their own medical expenses, less amounts paid from shared dollars. 

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