Serving and being served

Part 1 of 2

AJ spends his days as a Provider Relations Specialist for Samaritan Ministries serving members by finding and negotiating fair prices for medical care.

But he ends up being served as well.

“The members are incredible witnesses to us on staff,” AJ said. “They are often just fully trusting in God. I have members who are calling on the phone and they’re more or less dying, and yet there’s so much joy in their voice. There’s just a light of God that’s shining through them. Even though we’re the ones helping them, they’re a witness to us.”

What is PRD?

The Provider Relations Department (PRD) was created in 2019 to consolidate efforts to find fair provider prices and as a way for the ministry to establish more relationships between Samaritan and medical providers.

It mainly helps members find quality care at good prices. Helping members to find a fair price with a quality provider before a procedure also avoids the need to negotiate after the service is provided.

The PRD team saved members more than $41 million in 2024.

PRD’s Upfront Services is a team of six, including AJ. That team helps members find fair prices before a planned procedure. Another team of 13 is focused on negotiations and payment confirmation.

AJ focuses on connecting members with providers before a procedure or treatment is scheduled to help the members find a fair price. It’s one of the reasons AJ wanted a job in Provider Relations.

“It really excited me because I saw this proactive effort for members,” he said. “We have a list of surgery centers that have been heavily vetted by our team. Through the vetting process, we know that these providers not only work well with cash-pay patients and offer high quality care, but they also offer significantly lower pricing on common surgeries.”

He also loves the team.

“There are varying amounts of expertise and experience on our team,” AJ said. “You have to lean on others to come up with the best solutions for members. Every situation is different. It’s almost always handled on a case-by-case basis. Wisdom is a must. I can’t imagine doing the work that I’m doing right now without the people on my team.”

Working with the members

AJ calls much of what he does “member education.” He emphasizes that he and others on his team help members realize that “just because you’re getting a hefty discount, a large discount oftentimes doesn’t necessarily mean that you’re getting a fair price.”

For instance, getting a 50 percent discount from a provider who charges $40,000 for a procedure is not as good as finding a provider who provides a 10 percent discount on a $20,000 charge for the same procedure.

AJ also says he enjoys working with the members.

“A lot of them have a heart for savings and have a heart to serve the ministry and trying to get as good a price as possible,” he said.

However, members don’t always have the tools and experience that Provider Relations specialists do, so specialists like AJ get to help them.

“We empower members to save money for the ministry at the end of the day,” he said. “So it’s not just on us anymore, not just on Provider Relations doing negotiations, but it’s also our members who then have the know-how.”

PRD also will have those conversations with providers on the members’ behalf if needed.

“That’s the large part of what we do,” AJ said. “I will advocate for the member coming in as a cash-pay patient. I will advocate for them as a Samaritan Ministries member. I will advocate for us as a health care sharing ministry.”

Reluctant providers

AJ must sometimes work with providers hostile to health care sharing ministries because such ministries aren’t health insurance. In that case, he explains Samaritan’s approach to health care sharing to them.

“We assist members to receive shares from other members,” he explains to providers. “It’s no different than receiving funds from friends, family, or fellow church members.”

He wants to communicate to providers—and members—that “The member is not alone in this.”

“We’re giving assurance to the provider that this should be shared, let them know how sharing works,” he said.

That also turns it into a Christian witness to the provider and is another step in redeeming health care.

“Oftentimes, providers are gracious by the grace of God, and they’re willing to work with the members after we’ve contacted (the providers),” AJ said.

Empowering members

Through their research, Provider Relations specialists sometimes gather information, such as a specific provider’s typical self-pay discounts, and then pass that information to the member.

“So there may be an opportunity there, and that goes back to the empowering and educating of the member if they hadn’t actively worked for discounts at that point,” AJ said.

However, AJ and other specialists go into action primarily as a result of contacts by members. The members will frequently tell PRD that providers are asking them to pay upfront to receive service or to receive discounts.

“We actually have a lot of proactive communications with members,” he said.

PRD also will go through new needs and filter them by diagnosis to find something they may be able to help with. For instance, a member may have a planned knee surgery. PRD will send them an email with suggestions, including surgery centers with discounted rates they may want to investigate. Or they will direct members to Healthcare Bluebook™, available to all members in the Health Resources section of their Samaritan Dashboard.

Other times, it’s something like an ongoing cancer need, with a provider expecting $100,000 or more for a treatment.

When those come up, AJ tells members, “You’re not alone. Definitely call. Discuss that with us.”

“I praise God that I’m able to see His hand in our work on a daily basis and able to see Him just making a path, making a way,” he said.

To reach the Provider Relations Department, send an email to [email protected].