Navigating a health procedure can be stressful without a plan or the right help, especially if it’s your first time. At ShareWELL, we’re committed to making this process as smooth and straightforward as possible. This guide will walk you through the steps you must take once you learn that you need a procedure.
Step 1: Submit a Sharing Request
Once your doctor has recommended a procedure, it is crucial to notify ShareWELL as soon as possible. You will do this by submitting a sharing request. Visit the link below to find detailed instructions on how to submit your request:
Submitting a Sharing Request Instruction
Step 2: Declare Yourself as a Self-Pay Patient
As a member of ShareWELL, you will be a self-pay patient. This allows you to receive self-pay discounts and be billed directly for any expenses associated with your procedure. To learn more about being a self-pay patient, please visit:
Embracing Self-Pay as a ShareWELL Member: Simplifying Healthcare and Empowering Your Choices
Step 3: Eligibility
After you have submitted your sharing request, we will determine the eligibility for sharing. This process may require you to sign a HIPAA form, allowing us to gather medical records from your provider. All requests must follow the member guidelines to be eligible for sharing.
Step 4: UA Responsibility
Once your request has been determined eligible for sharing, your Unshared Amount (UA) will need to be met. This UA amount was selected by you when you enrolled with ShareWELL. You can pay this amount directly to ShareWELL or make payments to your provider and submit the corresponding itemized statement and payment receipt.
Step 5: Bill Submission
You may be informed that your procedure requires pre-payment. In this case, you will need to collect a Good Faith Estimate, which provides self-pay patients with an estimate of the costs due for the procedure. This estimate should cover facility costs, physician costs, and anesthesia, depending on your provider. Request this information from your scheduled provider to obtain the correct Good Faith Estimates. We need these documents for pre-payment to be made.
If your provider does not require pre-payment, you will receive the bills directly from your provider since you have declared yourself as a self-pay patient. Submit these bills to us, and we will begin making payments.
Your Right to a Good Faith Estimate and What It Means ” The ShareWELL Difference”
Choosing a Provider with ShareWELL – UA Reduction Program
ShareWELL offers you the flexibility to choose your healthcare providers and services, allowing you to explore both traditional and nontraditional healthcare options. In certain instances, members can go above and beyond to keep costs down for the community. ShareWELL may authorize the reduction of a member’s UA when they take specific actions that result in significant savings. These actions include: Here are some tips for selecting a provider:
- Fair Cost Providers: Look for providers who offer fair and transparent pricing for their services.
- Centers of Excellence: Utilize Centers of Excellence approved by ShareWELL for high-quality care and cost-effective treatment options.
- Travel for Care: Traveling a significant distance to a fair cost provider.
We hope this guide helps you navigate the steps necessary to manage your procedure with ShareWELL. Remember, our team is here to support you every step of the way. If you have any questions or need further assistance, please contact our member services team.
For more information and resources, visit our website or reach out to us directly.