Aultman guide – hospital and doctor visits
How to access Aultman with your Sidecar Health coverage, frequently asked questions about Aultman, and alternatives to Aultman.
The information in this article pertains to non-emergency services rendered at Aultman. If you have an emergency and want to go to a Aultman 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.
Aultman services and costs:
Aultman is a health system located in a five-county region of Stark, Tuscarawas, Holmes, Carroll and Wayne counties with 3 hospitals and physician groups with over 700 physicians across numerous specialties and locations. With your Sidecar Health coverage, you can see any doctor for your treatment, including those at Aultman. Sidecar Health does not use networks: we do not have a provider agreement with Aultman. 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. Aultman is included in these guides so you can see how their general pricing compares to other provider options in your region.
Accessing an Aultman provider at an office location (e.g., primary care and specialty care visits):
- Call your Aultman 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 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 Aultman Hospital Patient Accountant 800-900-6321 to get a detailed itemized medical invoice.
Scheduling a visit or procedure at an Aultman hospital:
Click here for the list of Aultman hospitals.
There are two ways to schedule a visit or procedure at an Aultman hospital location. Note - both options pertain to non-emergency services only. If you have an emergency and want to go to an Aultman hospital for emergency care, go get care right away. You are covered.
Option 1: Self-service.
- Call the Aultman Hospital Customer Service at 330-363-6321 Option 2, 1-800-900-6321 option 2 or by email at pa@aultman.com and ask for a good faith estimate for your service as a self-pay patient who pays promptly. I
- 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 Aultman Centralized Scheduling at 330-363-6288.
- 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 to the Sidecar Health member portal within 90 days of your service date. If your invoice is rejected for missing details, contact the Aultman Hospital Patient Accountant 800-900-6321 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 Aultman.
- 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 to the Sidecar Health member portal within 90 days of your service date. If your invoice is rejected for missing details, contact the Aultman Hospital Patient Accountant 800-900-6321 to get a detailed itemized medical invoice.
FAQs:
What discounts does Aultman offer?
Aultman may offer discounts for patients who pay promptly. Contact your provider at Aultman or your the Aultman 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 Aultman, 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 Stark, Tuscarawas, Holmes, Carroll and Wayne counties:
