Wellstar guide – hospital and doctor visits

How to access Wellstar with your Sidecar Health coverage, frequently asked questions about Wellstar and alternatives to Wellstar.

The information in this article pertains to non-emergency services rendered at Wellstar. If you have an emergency and want to go to a Wellstar hospital for emergency care, go get care right away. You’re covered and won’t be responsible for emergency room charges over your deductible. Learn more about your coverage here.

Wellstar services and costs:

Wellstar is a health system located in northwest Georgia with 10 hospitals and a physician group with more than 1,150 physicians across numerous specialties and locations. With your Sidecar Health coverage, you can see any doctor for your treatment, including those at Wellstar. Sidecar Health does not use networks: we do not have a provider agreement with Wellstar. Rather, you’re free to compare their pricing to Sidecar Health Benefit Amounts (what your plan pays) so you can choose where to get care.

When selecting providers: 

1. Find your Benefit Amounts in the member portal.
2. Shop for care by comparing your Benefit Amount to provider prices in your area.

Accessing a Wellstar provider at an office location (e.g., primary care and specialty care visits):

1. Call your Wellstar office directly to schedule care and ask for their pricing to compare against your Benefit Amount.

Here’s what to say: “Can you provide a good faith estimate for a visit, including any incremental fees (such as facility fees, test, and lab costs) that I could expect? I have health insurance, but it works differently than most other traditional insurance plans. It's important I understand the cash-pay total for my visit ahead of time so I can choose a provider that charges in the range that my insurance company reimburses me. I will pay you directly in full for the visit, but I will need an itemized medical invoice after the visit.”

2. Schedule your care. Use the Sidecar Health VISA benefit card if you are required to pre-pay or pay a deposit to confirm your appointment.

3. Get care at your scheduled office location.

4. Upload the invoice or medical statement you receive from your MyChart or through paper mail to the Sidecar Health member portal, within 90 days of your service date. If your invoice is rejected for missing details, contact the Wellstar Health Customer Service Line at 470-245-9998 to get a detailed itemized medical invoice.

• How to get your itemized invoice from MyChart for Wellstar Health System.

Scheduling a visit or procedure at a Wellstar hospital:

Click here for the list of Wellstar hospitals. 

There are two ways to schedule a visit or procedure at a Wellstar hospital location.

Note - both options pertain to non-emergency services only. If you have an emergency and want to go to a Wellstar hospital for emergency care, go get care right away. You are covered. 

Option 1: Self-service.

1. Call the Wellstar Shoppable Services Line at [phone] and ask for a good faith estimate for your service as a self-pay patient who pays promptly. If you have an existing MyChart with Wellstar, you may be able to do this directly through your MyChart. Learn how here.
2. Submit your good faith estimate as a “pre-bill” through the Sidecar Health member portal, and Sidecar Health will help you understand your Benefit Amounts and any costs you may be responsible for. We will also authorize the Sidecar Health VISA benefit card to swipe for the charges if the payment is greater than $2,500.
3. If scheduling was not taken care of by the shoppable services line and you have an existing MyChart with Wellstar, you may be able to do this directly on your MyChart.
4. Use the Sidecar Health VISA benefit card if you are required to pre-pay or pay a deposit to confirm your appointment.
5. Get care at your scheduled hospital location.
6. Upload the invoice or medical statement you receive from your MyChart to the Sidecar Health member portal within 90 days of your service date. If your invoice is rejected for missing details, contact the contact the Wellstar Health Customer Service Line at [phone] to get a detailed itemized medical invoice.

Option 2: Let us help you.

1. Before scheduling care with your provider, call Member Care at [phone]. Explain your care needs, provider preferences or submit any documentation you have on hand.
2. Our Member Care team will kick off Provider Location Assistance, a service that offers you convenience and protection:
   • We help you shop and ensure you always have the option to receive care within the Benefit Amount, meaning without balance billing. Please note that the most affordable option presented may not always be Wellstar.
   • You’ll have more clarity around your benefits and your coverage.
   • You will not be responsible for unplanned procedures that happen during a planned event.
3. Select the provider that best suits your needs and schedule care.
4. Upload the invoice or medical statement you receive from your MyChart to the Sidecar Health member portal within 90 days of your service date. If your invoice is rejected for missing details, contact the contact the Wellstar Health Customer Service Line at [phone] to get a detailed itemized medical invoice.

FAQs:

What discounts does Wellstar offer?

Wellstar may offer discounts for patients who pay promptly. Contact your provider at Wellstar or your MyChart price estimator tool to confirm eligible discounts for your care.

To better understand how this compares to your Sidecar Health benefits, you can submit a good faith estimate as a “pre-bill” through the Sidecar Health member portal. If you are unable to obtain a good faith estimate from your provider, we will help you. Call Member Care at [phone].

What should I say when they ask about insurance?

“I have insurance through Sidecar Health, but it works differently than most other traditional insurance plans. I’ll pay you directly in full for the care I receive and then I'll need you to provide me with an itemized medical invoice. I’ll work with my insurance company on the back end so you don’t have to. I understand that this may make me eligible for a self-pay and/or prompt pay discount.”

You can also share the information found on your Digital Member ID Card.

What should I do if I am struggling to access Wellstar, get a good faith estimate, or get an itemized medical invoice?

We encourage you to always submit whatever documentation you may have to the Sidecar Health member portal. If we are unable to process your pre-bill or claim with that information, we will reach out to you and step in to help obtain missing information if needed.

Still need help shopping for care?

At any time, you can call your Member Care team at [phone] and we will help you find you a provider option at or below the Benefit Amount.

Other providers in northwest Georgia: 

Emory Healthcare guide

Northside Hospital guide