ProMedica guide – hospital and doctor visits
Healthcare can be complicated, but Sidecar Health is here to help simplify your experience. In this article, we will explain how to access ProMedica with your Sidecar Health coverage, frequently asked questions about ProMedica, and alternatives to ProMedica.
Note – This information pertains to non-emergency services only. If you are experiencing an emergency, we have you covered. Learn more here.
Benchmarking ProMedica services and costs:
ProMedica is a health system located in northwest Ohio with 11 hospitals and a physician group with more than 800 physicians across numerous specialties and locations. Sidecar Health does not have a partnership with ProMedica; with your Sidecar Health coverage, you can still see any doctor and facility for your treatment.
As a Sidecar Health member, you are in the driver’s seat of your own healthcare decisions. With your Sidecar Health coverage, you can see any doctor including those at ProMedica, but it is up to you to shop smartly for the provider that best fits your needs. Some procedures, imaging, lab work, etc. may be higher than the Benefit Amount in northwest Ohio*. Always remember to submit a good faith estimate as a “prebill” through the Sidecar Health member portal so our team can help you fully understand your Benefit Amounts and costs.
Accessing a ProMedica provider at a non-hospital location (e.g., imaging centers, primary care office, ambulatory surgery center):
- Call your ProMedica office directly to schedule care and ask what your service would cost as a self-pay or cash-pay patient.
- Schedule your care. Use our 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 non-hospital location.
- Upload the invoice you receive to the Sidecar Health member portal. If your invoice is rejected for missing details, contact ProMedica Customer Service at 844-373-0871 to get a detailed itemized medical invoice.
Scheduling a visit or procedure at a ProMedica hospital:
Click here for the list of ProMedica hospitals.
- Call ProMedica Customer Service at 800-477-4035 and ask for a good faith estimate for your service as a self-pay or cash-pay patient.
- 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 your 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 Customer Service, call ProMedica Enterprise Scheduling at 419-291-3000.
- Use our 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.
- Upload the invoice you receive to the Sidecar Health member portal. If your invoice is rejected for missing details, contact ProMedica Customer Service at 844-373-0871 to get a detailed itemized medical invoice.
FAQs:
What discounts does ProMedica offer?
ProMedica may offer discounts for self-pay or cash-pay patients who pay promptly. Contact your provider at ProMedica or check the ProMedica price estimates tool to confirm pricing for your care.
To better understand how this compares to your Sidecar Health benefits, you can submit a good faith estimate as a “prebill” through the Sidecar Health member portal.
What should I say when they ask about insurance?
Previous members have had success with ProMedica by saying, “Yes, I do have insurance through Sidecar Health, but I will be paying as a self-pay patient. Please charge your self-pay or cash-pay patient price. I will pay in full using a VISA card and will handle insurance claims afterward, directly with my insurance provider.” You can also share the information found on your Digital Member ID Card.
I understand that this may make me eligible for a self-pay and/or prompt pay discount.”
What should I do if I am struggling to access ProMedica, 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 let you know what else we need. You can also call your Member Care team at 877-653-6440 and we will support you in getting the care or information you need.
Still need help shopping for care?
Our Member Care team would be happy to assist you. Give us a call at 877-653-6440.
Other providers in northwest Ohio:
*Based on Sidecar Health member experience and claims through December 2022. Sidecar Health does not utilize a network of providers. External websites and information on healthcare providers, including cost and quality information, is provided for convenience and informational purposes and is not an endorsement or guarantee of pricing, quality, or availability of the provider. Contact the provider for pricing and availability. Sidecar Health bears no responsibility for the accuracy, legality or content of any external websites or for subsequent links from an external site.
