Thank you for being a valued member at OneShare Health. This page is your guide to the pre-notification process, ensuring you're fully supported in making informed decisions about your care. Our goal is simple: to make this step as seamless as possible, keeping you in the loop about your eligibility for sharing and connecting you with top-notch care. Let's navigate this path together, empowering you with choice and clarity at every turn.
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Pre-Notification: To be eligible for consideration for sharing, Pre-Notification is required for the following:
Pre-notification submissions can be submitted by phone at (855) 699-0419, by email at firstname.lastname@example.org, or by fax at 682-477-3868.
You can download the pre-notification form by clicking the button below:
Our goal is to help our Members avoid unnecessary services and Hospitalization, to improve the quality of care, and empower our Members to make informed medical choices. We strive to make our Members’ experiences as simple as possible, to help Members understand what care is available, and to give our Members access to the best Providers with the highest quality and value for their procedure. OneShare Health does not mandate the medical treatment a Member chooses. Our Member Support tools are available to help Members navigate their health care journey and make informed choices for their care. If a Member would like to Nominate a Provider, please click here.
Even if you have completed the Pre-Notification process with OneShare Health, this does not guarantee your medical need is Eligible for Sharing. Considerations such as Membership status, Pre-Existing Conditions, Cancer Eligibility, and Program Limitations are considered when determining sharing eligibility.
Per program guidelines, Pre-Existing Condition means: (1) any sickness or injury for which a Member, within 24 months before the Member’s Active Date, received medical treatment, advice, care, or services (including diagnostic measures), took prescribed drugs, or showed signs and symptoms (whether treated or not), or (2) any chronic, persistent, or long-lasting medical condition which is unresolved and known to the Member, regardless of whether, within 24 months before the Member’s Active Date, the condition required treatment, advice, care, services, or prescription drugs, or exhibited any signs or symptoms. Eligibility for a Pre-Existing Condition, or for any medical condition caused by or directly related to a Pre-Existing Condition, has a 24-month Waiting Period.
If you do not agree with the determination made during the prenotification review, you may submit a written appeal by clicking on the link. https://www.onesharehealth.com/member-disputes
There are three options when submitting a prenotification request: Standard (10-14 business days), Quick Response (7-10 business days), and Expedited (1-10 business days) after all necessary information has been collected. I.E. Medical record release forms, medical records from all providers or facilities needed for Clinical Review to determine eligibility.
Not all scans require a Pre-Note. Here is a list of “Non-Invasive” tests that do not require a Pre-Note:
Screening Colonoscopies don’t require a Pre-Notification unless partnered with a Biopsy.
*The recommended age for a screening colonoscopy is 45 or older. Under 45 if the member has a family history.*