Coral Pre-Pay Guide
FOR PROVIDERS
Coral has expanded to add over 300,000 lives, with over 1.3 billion in spend through new partnerships with Sharing Ministries and Indemnity plans. These programs have all made exclusive deals with Coral to pre-pay for services if they're bundled. With that said, there are a few things you need to know.
1. In all cases, you need to issue a pre-payment request. Each Coral Pre-Pay customer has a customer workflow and integration, that's tailor made for this process, to ensure their members can be pre-funded for their care. Issuing a prepayment request is the most critical part of the process.
2. IMPORTANT: Please ensure you see "pre-payment confirmed" in the referral before you schedule a member. If you give services to a member without getting a pre-paid voucher in Coral, you may not be paid for the services you deliver.
-This is true for consultations, imaging, colonoscopies, etc. There are no exceptions. We want to make sure you are paid promptly for any services on Coral.
*Coral is not a collections company. If your company does not want these cases, please notify us at your earliest convenience.
3. If you think your procedure has a high probability of having a price change during surgery, please price that into your bundle. For example, Hysterectomies and Cardiology procedures sometimes get more expensive. We recommend you either turn down the procedure, or account for the volatility in pricing. You can always refund money after the fact, but sometimes it can be difficult to get more money once the patient has had services rendered.
NOTE: For Indemnity plans like New Era or Philadelphia American Life - Inpatient services are not eligible.
4. For Sharing Ministries, there are fewer restrictions, and in-patient care can be covered. You will still be subject to the terms of a bundle, unless you propose a single case agreement on a % of medicare, that is submitted and accepted by the Coral Pre-Pay account.
5. For Sharing Ministries, it is sometimes easier to get funds after the fact, but communication is key. We do not want you or your organization to be stuck taking a loss on ANY Coral case.