Summa Health guide – hospital and doctor visits
How to access Summa Health with your Sidecar Health coverage, frequently asked questions about Summa Health, and alternatives to Summa Health.
The information in this article pertains to non-emergency services rendered at Summa Health. If you have an emergency and want to go to a Summa Health 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.
Summa Health services and costs:
Summa Health is a health system located in northeast Ohio with 4 hospitals and physician groups with over 1,000 physicians across numerous specialties and locations. With your Sidecar Health coverage, you can see any doctor for your treatment, including those at Summa Health. Sidecar Health does not use networks: we do not have a provider agreement with Summa Health. 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:
- Find your Benefit Amounts in the member portal.
- Shop for care by comparing your Benefit Amount to provider prices in your area.
The below local care guides were developed to help you identify providers in your area whose charges are typically at or below the Benefit Amount. Summa Health is included in these guides so you can see how their general pricing compares to other provider options in your region.
Accessing a Summa Health provider at an office location (e.g., primary care and specialty care visits):
- Call your Summa Health 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 insurance plans. It's important I understand the total cost 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.”
- 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.
- Get care at your scheduled office location.
- 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 Summa Health Billing Department at 234-312-5700 to get a detailed itemized medical invoice.
Scheduling a visit or procedure at a Summa Health hospital:
Click here for the list of Summa Health hospitals.
There are two ways to schedule a visit or procedure at a Summa Health hospital location. Note - both options pertain to non-emergency services only. If you have an emergency and want to go to a Summa Health hospital for emergency care, go get care right away. You are covered.
Option 1: Self-service.
- Call the Summa Health Price Estimate Line at 800-258-8081 option 5 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 Summa Health, you may be able to do this directly through your MyChart. Learn how here.
- 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.
- If scheduling was not taken care of by the price estimate line, call the Summa Health Central Scheduling at 330-996-8881 or 877-996-8881. If you have an existing MyChart with Summa Health, you may be able to do this directly on your MyChart.
- Use the Sidecar Health VISA benefit card if you are required to pre-pay or pay a deposit to confirm your appointment.
- Get care at your scheduled hospital location.
- 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 Summa Health Billing Department at 234-312-5700 to get a detailed itemized medical invoice.
Option 2: Let us help you.
- Before scheduling care with your provider, call Member Care at 855-282-0822. Explain your care needs, provider preferences or submit any documentation you have on hand.
- 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 Summa Health.
- 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.
- Select the provider that best suits your needs and schedule care.
- 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 Summa Health Billing Department at 234-312-5700 to get a detailed itemized medical invoice.
FAQs:
What discounts does Summa Health offer?
Summa Health may offer discounts for patients who pay promptly. Contact your provider at Summa Health 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 855-282-0822.
What should I say when they ask about insurance?
“I have an insurance plan through my employer and it works differently than most other typical insurance plans. I’ll pay you directly in full for the care I receive (whenever you need me to pay), similar to a self-pay patient. After my visit, I’ll need you to provide me with an itemized medical invoice. I submit that to my insurance company so they can apply my benefits. I work with them on the back end so you don’t have to.
Some providers offer a discount for patients like me that pay right away. Is that the case for you too? I’ve heard it called a “prompt pay” or “self-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 Summa Health, 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 855-282-0822 and we will help you find you a provider option at or below the Benefit Amount.
Other providers in Southwest Ohio:
