Navigating a Health Procedure with ShareWELL
Facing a medical procedure can feel overwhelming, especially without a clear plan. At ShareWELL, we’re committed to guiding you through every step. Our advocacy team is here to support you, whether helping you communicate with providers, quickly setting up self-pay arrangements, sending documents, or coordinating cost negotiations. Your active involvement remains crucial, particularly for planned procedures where time sensitivity can impact your care and costs. While ShareWELL Partners will move swiftly on your behalf, provider offices often work slowly, making prompt cooperation essential.
Step 1: Submit a Sharing Request
As soon as your doctor recommends a procedure, submit your Sharing Request. Acting early gives you the best chance to:
-
Coordinate smoothly with providers and ShareWELL Partners
-
Lock in discounted or bundled rates
-
Resolve billing issues before they disrupt care
-
Reduce stress leading up to your procedure
The sooner we begin, the more options we have to protect your time, health, and finances.
Step 2: Choose the Right Setting for Your Care
One of the biggest ways to save is by choosing the right place for your procedure. Whenever possible, ShareWELL encourages members to consider ambulatory or surgical centers outside of large hospital systems.
Why?
-
Lower costs – Hospital systems often add significant overhead charges, while surgical centers provide the same procedures at a fraction of the price.
-
High quality – Many centers specialize in specific procedures, leading to excellent outcomes and efficient care.
-
Faster process – Billing and scheduling are often simpler and more transparent than hospital systems.
Our advocacy team can help you identify these options, compare prices, and even reduce your Unshared Amount (UA) when you choose cost-conscious providers.
Step 3: Eligibility Review
Once your sharing request is submitted, we’ll begin the eligibility review. You may be asked to sign a HIPAA form so we can request the necessary medical records. Eligibility decisions are based on ShareWELL’s Member Guidelines. Timely cooperation in providing documents and signatures is essential to avoid delays.
Step 4: Identify as a Self-Pay Patient
Let your provider know you are a self-pay patient right away. This unlocks transparent, upfront pricing and avoids inflated charges. ShareWELL’s advocacy team can offer instruction on how to communicate with providers and secure clear estimates.
Step 5: Meeting Your UA (Unshared Amount)
Once your procedure is deemed eligible for sharing, you’ll need to meet your Unshared Amount (UA), which is the portion of costs you’re responsible for. You can pay this directly to ShareWELL or your provider. Our team is ready to assist if you have questions or need help navigating this step.
Step 5: Prepayment and Bill Submission
As a self-pay patient, prepayment is almost always required, and that’s exactly how we want it. Prepaying for your procedure, which includes physician, facility, and anesthesia bills, typically results in significantly better pricing and a smoother experience overall. It simplifies the process, eliminating the need to handle bills after the procedure.
To move forward, request a Good Faith Estimate outlining the expected charges from your provider. Our team may initiate attorney-led negotiations to advocate for a fair bundled rate if the estimate seems unreasonably high. We can commit to working on your behalf promptly with your cooperation. Since providers often respond slowly and multiple departments may be involved, your fast response makes a major difference.
Choosing a Provider with ShareWELL – UA Reduction Program
ShareWELL gives you the flexibility to choose your provider—traditional or nontraditional. Sometimes, members who go the extra mile to help control costs may qualify for a UA reduction. These actions include:
-
Choosing providers or centers with transparent, fair pricing
-
Traveling to lower-cost facilities when possible
-
Responding quickly during the negotiation process
Our advocacy team can help you explore options and connect with providers who meet these criteria.
Final Thoughts
ShareWELL is here to support you every step of the way. Our advocacy team stands ready to assist with provider communication, document coordination, and payment arrangements. But your role is just as important, especially when procedures are time-sensitive or billing issues arise. The sooner we receive what we need, the more effectively we can help you secure fair pricing and high-quality care.
If you have questions or need help, reach out to our Member Success team or visit our website for more resources.