Glossary

Authorize

Authorization is the process all medical bills undergo once they are submitted to the CHM office. CHM’s Member Bill Processing representatives approve bills for sharing according to the CHM Guidelines and the member’s participation level.

Bring-a-Friend

Bring-a-Friend is a referral program in which members encourage Christian friends, neighbors and extended family to join CHM and benefit from the joy of knowing that their monthly financial gifts also will help other Christians. To learn more, visit our Bring-a-Friend page.

Brother's Keeper

Brother’s Keeper is a program for medical bills exceeding the $125,000 per-illness sharing limit in our regular three programs. To learn more, see our catastrophic medical bills page.

Checklist of Understanding (COU)

The Checklist of Understanding (COU) is a legal document stating you understand that CHM is a voluntary cost-sharing ministry and not a health insurance company. The COU must be on file with Christian Healthcare Ministries before we can share your medical needs; it corrects insurance regulators who may incorrectly assume that CHM members do not understand the difference between voluntary health cost-sharing and health insurance.

Illness

An illness is a diagnosis of a disease, injury, or medical condition that has been identified and can be treated once or multiple times (multiple incidents). CHM sharing limits are determined by illness. Members can receive up to $125,000 per illness in the regular sharing program and up to $1 million or more per illness by participating in the Brother’s Keeper program.

Example 1: Diabetes is an illness that can be treated at a maintenance level but can flare up and create an incident. The incident (medical bills related to the flare-up) has a definite start and end date; the illness can last a lifetime.

Example 2: Your knee hurts so you go to the doctor, who orders an MRI. After viewing your test results, he diagnoses you with arthritis. He gives you a cortisone shot and your knee soon feels better. The diagnosis of arthritis in your knee is an illness. The medical examinations, testing and treatment you undergo is an incident. Two years later, your knee starts to hurt again. You return to the doctor, who says your arthritis has flared up. He gives you another cortisone shot. After two weeks, you go back because it still hurts. He tells you that you need a knee replacement and schedules the surgery. You undergo surgery and physical therapy. After a few months, he gives you a clean bill of health. This scenario describes a second incident within the illness of arthritis in your knee.

Incident

An incident includes medical treatment or testing that lasts until one of the following events occurs:

1) a certain medical condition is cured according to official medical records;

2) treatment is at a routine maintenance level; or

3) you experience 90 days without any kind of treatment for that particular condition (testing or treatment must be an eligible expense at your chosen level of participation: Gold, Silver, or Bronze).

The medical bills incurred from the first test to the last treatment before the doctor releases you to a regular, routine maintenance regimen are considered a single incident. If 90 days pass and you receive no further treatment, any future bills you incur will be considered a separate incident. Personal responsibility amounts for the Silver and Bronze participation levels are per incident (for info about the Gold level, see our Programs page).

Example: You go to the doctor due to pain in your side. He examines you and gives you some instructions before sending you home. The next week you return because the pain has continued. The doctor orders a blood test and an ultrasound. After reviewing the results, he diagnoses you with appendicitis and sends you to the hospital. He performs an appendectomy. The hospital releases you with instructions to visit the doctor’s office in one week for follow-up. At that visit the doctor tells you come back again the following week, at which time he pronounces you cured. Medical bills you incur for each of these situations fall under the category of a single incident.

Itemized bill

A receipt is not an itemized bill; a receipt only shows what has been paid and doesn't include information about what services were performed. To share medical costs, CHM requires itemized bills, which contain all of the following:

  • the patient's name
  • the date of service
  • the place of service
  • the procedural (CPT) codes (or description of services rendered)
  • the charge for each service rendered

Lifetime maximum

Lifetime maximum is the total amount CHM will share through the regular sharing program. Members can receive up to $125,000 per eligible illness. Please see Guidelines for information on the Brother's Keeper program for additional sharing.

Member Gift Form

The Member Gift Form (MGF) is a monthly billing statement notifying you that your financial gift amount is due. Along with your membership account statement, the Member Gift Form includes a ministry update letter each month. Reading the letter keeps you informed on ministry policies, activities and events.

Magazine

The CHM monthly magazine, Heartfelt, contains articles and information helpful and relevant to ministry members. All members are strongly encouraged to read each issue to stay up-to-date on CHM news, activities, and policy changes.

Personal responsibility and qualifying amount per incident

Your qualifying amount per incident (QA) is the amount each incident must total (before discounts) to be eligible for sharing. This amount does not change and applies to each incident individually.


Your Personal Responsibility (PR) is the amount that each membership unit is responsible to pay each year. It’s possible for this single amount to apply across multiple incidents. For example: a Gold member submits an eligible $1,200 bill with $300 discount. This would mean the member pays the difference of $900 and that individual (or children unit) still has $100 left to fulfill their PR.

 

Your Bring-a-Friend credits can apply toward your Personal Responsibility amount. Members are responsible to pay incidental medical expenses, such as maintenance prescriptions, dental expenses, etc. (See our prescriptions and dental and vision pages for more info.)

Gold program incident example:

You receive treatment early in the year for a gallbladder problem. Your bills total $7,500 and you receive $2,500 in healthcare provider discounts. After you pay your Personal Responsibility of $1,000, CHM shares $4,000 ($7,500-$3,500), 100% of the cost after paying your Personal Responsibility.

In the middle of the same year you have some blood tests done (for an unrelated illness) that cost $400. CHM does not share any of these bills because the total cost of the incident is less than your qualifying amount per incident of $1,000.

At the end of the year, you break your arm and the treatment amounts to $2,500. CHM shares the entire amount of $2,500 because the incident totals more than $1,000, you've paid your Personal Responsibility, and the treatment meets all other CHM Guidelines.

Pre-existing conditions

The CHM Guidelines define a pre-existing condition as any medical condition for which you experience signs, symptoms, testing or treatment before joining Christian Healthcare Ministries. (Routine or maintenance medications are considered treatment.)

For example, if you have a stent that was inserted for a heart condition, the stent is considered treatment and your heart condition is pre-existing.

Reduction (discount)

A reduction is a discount given by a healthcare provider. CHM members are technically self-pay patients and often qualify for discounts on their medical bills. Discounts represent about 60 percent of all medical bills submitted to CHM; without them, CHM monthly financial gifts could be more than twice as high. Please don't be shy about asking for a discount. To learn more, see our Provider Interaction page.

Share/Sharing

Sharing occurs when CHM sends funds (members’ monthly financial gifts and extra gifts) to members whose medical bills are eligible according to the CHM Guidelines, or when the ministry reimburses members who paid for eligible medical expenses out-of-pocket. We take care to make sure our members understand that CHM is not insurance and does not assume the legal obligation to pay your medical bills. Your fellow members voluntarily share your medical bills and you use that money to pay your bills. Since 1981, CHM members practicing their faith have given money each month to share each other’s medical expenses.

Sharing level/participation level

There are three programs from which members can choose: Gold ($235 per unit, per month), Silver ($135 per unit, per month), and Bronze ($90 per unit, per month). The dollar amounts are called monthly financial gifts and are required for medical bill sharing eligibility. Medical bills are approved for sharing based on the CHM Guidelines and the member’s sharing level. Switching levels affects the amount and type of medical bills eligible for sharing.

Submit sharing requests/bills

Bills are submitted to CHM via the Member Portal, mail, or fax (we discourage the use of email since it isn’t a secure means of transmission. If submitting by mail, be sure to keep personal copies of your bills.) A complete guide to submitting bills is available by clicking here. CHM isn’t an insurance company and cannot be billed by healthcare providers. Members must be billed directly, after which members must send the itemized bills to the ministry within six months of the date of service. The faster bills are submitted to the CHM office, the faster they can be presented for sharing among CHM members. Bills are shared based on when they are received by the CHM office, not on when they are incurred.

Units

A unit is one qualifying individual. Two units are two qualifying immediate family members; three units are three or more qualifying immediate family members. No family’s monthly financial gift exceeds three units, regardless of the number of immediate family members. The number of units determines monthly financial gift and Personal Responsibility amounts.

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