Provider Resources
How to bill your patient
No networks. No provider restrictions.
Preventive care
Preventive services can vary depending on elected coverage. Our advocacy team can clarify what benefits are available.
Payment options include reimbursement directly to the member, or payment at the time of service. If they have the service include and you are willing to accept payment by phone contact ShareWELL Partners at 888-615-5025 and we can initiate a payment on behalf of the member.
Sick Visits
Sick visits to a doctor or urgent care usually under the Unshared Amount. If the cost is below members can be billed as self-pay patients and resolve expenses directly with their provider.
Unlike a traditional deductible, the Unshared Amount (UA) is a fixed amount applied per medical request. If bills do not accumulate to the Unshared Amount provided on the ID card a Sharing Request is not initiated.
Labs & Imaging
We recommend members use locations like Quest Labs or services we have provided to them for fair cost imaging services. Please refer your patient appropriately as a self-pay patient.
Unlike a traditional deductible, the Unshared Amount (UA) is a fixed amount applied per medical request. If bills do not accumulate to the Unshared Amount provided on the ID card a Sharing Request is not initiated. If they member has reached their Unshared Amount for this medical event we can help provide at time of service payment on behalf of the member by phone.
Emergency Room Visits
In a medical emergency, ShareWELL ensures your patients receive the urgent care they need. Provide an itemized statement to the patient with self-pay discounts applied.
As a self-pay patient, your patient will submit bills that exceed their Unshared Amount directly to ShareWELL through a Sharing Request. ShareWELL will advocate on behalf of your patient to ensure timely payment of bills, helping to secure any applicable discounts. Additionally, we assist members in auditing bills and negotiating overcharges, providing extra support to ensure fairness and accuracy in billing.
Recovery
Its first important to understand if your patient has met their Unshared Amount for this medical event. You will bill them as a self-pay patient for services performed. If they have exceeded their Unshared Amount we can help faciliate one time payments for single billed treatment plans.
When prescribed and performed by a licensed medical professional and related to an eligible Sharing Request, expenses for therapeutic and recovery treatments are eligible up to an allowance of $3,500 per Sharing Request. Services include but are not limited to, chiropractic, massage, physical therapy, acupuncture, hyperbaric chamber, ozone treatment, dry needling, prolotherapy, infusion therapy, craniosacral, occupational therapy, and speech therapy.
Maternity
Your patient will pay their Unshared Amount directly to you as a self-pay patient. We will help facilitate additional costs beyond their Unshared Amount in a timely manner. The member is responsible for submitting a sharing request and notifying ShareWELL within 15 days of confirming the pregnancy.
Your patient has the freedom to choose their care team, including midwives and doulas. We encourage you to work with members to create a prenatal and postnatal prepayment package to streamline the billing process. Once its created and submit we will help initiate a payments on the members behalf.
Submit A Sharing Request
ShareWELL functions differently from traditional plans. Rather than submitting claims, your patient will submit a "Sharing Request". Provide your patient with itemized bills that include self-pay discounts to facilitate the request.
Requests are submitted by members on a per-member, per-incident basis. Each Sharing Request is the sum of related eligible medical expenses incurred by receiving medically necessary treatment from licensed medical professionals and facilities, such as physicians, emergency rooms, and hospital facilities.
ID Cards
Ask the member if they have other ID cards in case other benefits plans are available to the member. Our ID card is designed to provide you their Unshared Amount and provide directions for your patient to navigate healthcare as a self-pay patient with the support of an advocacy tem.
If a member presents an ID card with a payor ID, you can use it to process claims for eligible expenses. However, if the member’s ID card does not include a payor ID, they must identify themselves as a self-pay patient and receive a direct bill for your services. In this situation, the member will submit a Sharing Request to ShareWELL to determine eligibility for expense sharing.
Other Plans & Benefits
ShareWELL Partners advocacy team can help answer questions for your patient or you about other plans and benefits that they may have.
Our patients often choose a customizable approach with includes specific benefits for preventive, labs, imaging, medications or discounted services. Our advocacy teams is here to help if your patient is unsure about their benefits.