What are pre-checked providers?

When searching for care in the member portal, you may notice providers with a pre-checked designation. These providers were selected due to popularity among Sidecar Health members for generally being at or below the Benefit Amount. You won't pay anything for your service at a pre-checked provider if your deductible is met or doesn’t apply to your service.

These providers do not comprise a network, rather they are choices available to you when deciding where to access care. This curated selection of providers is based on where you live and is focused on the service you've searched for in the member portal. 

What does "pre-checked" mean for you? 

Choosing a pre-checked provider listed on the Sidecar Health member portal can lower your out-of-pocket costs for specific services.

• Deductible is met or doesn’t apply to service
  • You won't pay anything for this service at this pre-checked provider.
• Deductible is not met and does apply to service
  • You will be responsible for the entire provider charge, up to your remaining deductible.
  • The amount applied to your deductible will depend:
    • If the provider charges at or below your Benefit Amount (usually the case): Your Benefit Amount will apply towards your deductible.
    • If the provider charges above your Benefit Amount: Their total charge will apply towards your deductible.

💡Savings pro-tip: While pre-checked providers are usually at or below the Benefit Amount, they might not always offer the absolute lowest price. So, if maximizing cash back is a priority, comparing prices with other local providers can be worthwhile. Here's the beauty: if a provider's price falls under your Benefit Amount, you keep the savings.

How does it work?

	1. Search for care in the member portal
	2. See pre-checked provider(s) in search results
	3. Confirm prices if the deductible *If your deductible applies and it hasn't been met, you're responsible for the provider charge, which may exceed the Benefit Amount.
	4. Schedule appointment with provider for the service you searched for *Ask if any discounts apply to you*
	5. Get care *Pre-checked providers for labs, imaging and facilities are often different, so check prices against Benefit Amount for other services or use a different pre-checked provider*
	6. Pay with your Sidecar Health VISA benefit card
	7. Upload itemized medical invoice to the corresponding expense *Ensure the itemized medical invoice for this service includes the name of the pre-checked provider before uploading to the member portal.

What do I do if I need a procedure or surgery?

We’ve pre-checked various affordable surgery centers and hospitals that are affiliated with your pre-checked provider. We call these, “pre-checked facilities”. Sometimes, the facility (where the surgery is performed), and the doctor (the physician who performs the surgery) are the same, and sometimes they are different. 

In searching for medical procedures, look to see if there’s a pre-checked facility included in the search results.

No pre-checked facility listed

If there’s no pre-checked facility, you’re good to move forward scheduling your procedure with the pre-checked provider listed on the page.

Pre-checked facility listed

Take a look at the corresponding facility we have pre-checked and ask your provider if you can have your procedure or surgery performed at that location. Important to note: Don’t reach out to the pre-checked facility to schedule the procedure.  Instead, ask the pre-checked provider to schedule your procedure or surgery to be performed at the listed pre-checked facility.  In most cases, the facility listed is where the pre-checked provider would typically perform the procedure you need.

What is a pre-checked facility?

Pre-checked facilities are surgery centers or hospitals that are affiliated with pre-checked providers. If you need to schedule a surgery or procedure, and a pre-checked facility is listed in the member portal under the pre-checked provider, do not reach out to the pre-checked facility to schedule the procedure.  Instead, ask the pre-checked provider to schedule your procedure or surgery to be performed at the listed pre-checked facility.

How do I find a provider in the practice?

In some cases, we have listed a provider group.

1. Click on the link to the provider’s website.
2. Navigate to the provider’s “find a doctor,” “physicians,” or similar section on the website.
3. If you are looking for a specific specialty, make sure to filter/limit your search to providers of that specialty.
4. If you’re ever unsure, call your Member Care team at [phone]. 

What do I do if my provider wants to refer me to a provider that hasn’t been pre-checked?

With Sidecar Heath, there are no networks. So, you’re always free to choose the provider that makes the most sense for you. If you want to be referred to a pre-checked provider, make sure to let your provider know where you would like to be referred.

You are always welcome to use our Provider Location Assistance service to help you understand your benefits for any provider. Please contact Sidecar Health at least 5 business days in advance of the scheduled appointment or procedure and ask for Provider Location Assistance.

What if I haven’t met my deductible?

The pre-checked provider price for the searched-for service is usually at or below the average cash price, in which case the Benefit Amount will apply to your deductible, and you will be responsible to the pre-checked provider for its charge. If the pre-checked provider charges more than the average cash price, then the provider’s charge will apply to the deductible. In such case, you will be responsible for the entire amount of the pre-checked provider’s charge, which may exceed the Benefit Amount shown in care search.

Can I see pre-checked providers for all care types?

When you see a pre-checked designation in the member portal, it applies exclusively to the specific service you searched for. If you’re looking for other types of care, conduct a new search to discover a corresponding pre-checked provider.

For example, a member scheduling a tonsillectomy in Cleveland might do the following:

• The pre-checked provider to remove tonsils is Ohio ENT and Allergy Physicians: This is where to find a doctor to perform the tonsillectomy
• The pre-checked providers for bloodwork are Labcorp and Quest Diagnostics: This is where to find providers to do the labs.
• The pre-checked facility for ear, nose and throat services is Ohio Surgery Center: This is where the doctor from Ohio ENT & Allery Physicians would perform the tonsillectomy procedure.

With Sidecar Heath, there are no networks. So, you’re always free to choose the provider that makes the most sense for you.

How do I pay for my care?

With your Sidecar Health VISA benefit card, you can always pay for any medical service up to $2,500. Check your member portal to confirm your swipe limit as it may be temporarily decreased if you have outstanding bills. You can also use your personal card and we will reimburse you. Call Member Care at [phone] for assistance with your card.

See a "no swipe" designation? 

Some pre-checked providers are also "no swipe" (look for the icon!). These providers offer special pricing when they bill Sidecar Health directly. Do not pay these providers upfront for your care, enjoy the convenience of skipping the swipe and invoice upload. Best of all? Their prices will not exceed your Benefit Amount. Learn more. 

Prefer to see a different provider?

That’s great, too.

Sidecar Health benefits are available to you for any provider of your choice, without restrictive networks. When you choose a provider who charges less than the Benefit Amount, you get to “keep the savings”. When you choose a provider who charges more than the Benefit Amount, you will be responsible for the difference. If the care you’re seeking applies to the deductible, you will be responsible for paying the provider charge. The Benefit Amount will then be applied to your deductible.