FAQs
Patient care is complex. Insurance doesn't have to be.
Contact Information
The best way to connect with Sidecar Health is through the Sidecar Health Provider Portal. If you require additional assistance, please call us at (866) 441-9993 or email us at provider@sidecarhealth.com. A member of our Provider Services team is ready to help you.
General Information
Since 2022, Sidecar Health has issued and administered employer-sponsored Major Medical health plans that provide members with a more transparent and flexible way to access healthcare. Sidecar Health plans lower costs for all by putting members in the driver's seat of their healthcare through transparency and eliminating restrictions that have become commonplace with legacy insurance.
Unlike legacy insurance plans that rely on a network of doctors and hospitals, we give members the flexibility to choose any healthcare provider without worrying about network limitations, and up to amount charged. We provide members with a Sidecar Health VISA card they can use to pay for medical services directly.
The same as any other commercial plan, Sidecar Health patients have a digital ID card with membership information. Providers can also verify member information through the Sidecar Health portal. That said, your experience serving Sidecar Health members should be essentially the same as handling self-pay patients; the main difference is that a full-fledged major medical insurer is standing behind them helping you feel secure you will be paid (usually at the point of service or even before).
No, Sidecar Health does not require prior authorization or eligibility checks for any services.
Provider Portal and Account Setup
Any provider can request a login for the Sidecar Health Provider Portal, but you must have a registered health system domain. Email addresses from free, publicly-available services like Gmail, Yahoo, etc., are not accepted.
Fill out the request form.
Upon completion of request form, you should receive an email with login credentials within 7-10 business days.
Sidecar Health doesn't require traditional credentialing. However, we do appreciate receiving an up-to-date provider roster. A provider roster is a list of your practice's active providers, including their NPI, contact information, and specialties. This helps us ensure the accuracy of our provider portal and ensure that our members have the most accurate information when selecting care.
Sidecar Health has a Member Portal, which provides transparency by displaying provider pricing for a wide range of services. This allows members to see up-front costs for various procedures and appointments, empowering them to compare their Benefit Amount (the amount Sidecar Health pays) and make informed decisions about their healthcare.
We recommend that all providers take advantage of Sidecar Health's innovative value proposition for immediate payments. If you're unsure whether you qualify, please fill out this form.
Billing and Claims
You usually shouldn't (see below). Unless there is a direct billing agreement, the patient has coordination of benefits (COB), or the claim falls under ER/NSA provisions, patients will pay you directly at the time of service. Before the patient leaves, they will request an "itemized medical invoice" or "superbill" to submit to Sidecar Health through our member portal. Ensure this document includes the following essential information:
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- Patient's full name
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- Provider's name, address, and NPI
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- Date(s) of Service
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- Itemized charge amount(s)
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- Procedure codes (CPT/HCPCS)
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- Diagnosis codes (ICD-10)
Yes, Sidecar Health can accept claims directly from providers. However, we only reimburse providers directly in the following cases:
- The claim is subject to NSA protections, such as Emergency room claims,
- The patient has other insurance that coordinates benefits with Sidecar Health, or
- You prefer to receive payment through a more traditional revenue cycle and have a "direct bill agreement" with Sidecar Health.
Provider resources specific to COB are available at sidecarhealth.com/providers/claims/. Billing instructions are on the back of the member's COB card and digital member ID card. You can also call our Provider Relations team for assistance.
Cash Payments and Pricing
Providers have the flexibility to set their own pricing for patients with Sidecar Health coverage. While many providers opt to use their standard self-pay or cash-pay rates for simplicity, you also have the option to create a custom fee schedule tailored specifically for our members. If you choose to go this route, we are here to assist you. We can provide benchmarks for average cash-pay rates in your area, helping you establish fair and competitive rates that both attract patients and support the profitability of your practice.
No - you may collect payment from patients whenever you like.
Many providers opt to collect a deposit or estimated payment up front, which can be refunded or supplemented later once the final costs are determined. All Sidecar Health members are provided with a Sidecar Health VISA card to cover the costs of covered services. This helps ensure steady cash flow for your practice and clearly communicates the patient's financial responsibilities.