Sakshi N.
Unfair and inappropriate decline of expense claim reimbursement by Sidecar for Preventive services through one of Sidecar's preferred providers
I have Sidecar Health Employer Insurance Plan and per the policy document, all Preventive services are exempted from the deductible and the entire fee under Preventive services are to be covered by Sidecar if one of their preferred providers are used for the services. I went to Southeast Medical Group (1800 Northside Forsyth Drive, GA 30041) for my annual wellness check on 5/7/2025 which is one of the preferred providers listed on Sidecar website. The doctor's office charged me an initial co-payment of $150 upfront at the time of visit and suggested the outstanding amount will be determined after the service and will be sent as an itemized bill through postal mail to my home address. I received a statement from doctor's office on 5/16 per which had the outstanding amount owed as $427.18. I made 2 different payments to doctor's office of $150 on 5/7/25 and $427.18 on 5/16 and submitted the itemized bills and receipt of payments on Sidecar website for reimbursement. Sidecar is now denying the reimbursement claim of $150 with the explanation that they only reimburse one claim per visit. This is clearly a fraud because both the expenses submitted are for a single visit for which doctor's office generated 2 separate bills. The total amount of the service as it shows on the itemized bill received on 5/16 is $577.18 which was split between $150 at the time of visit (5/7) and remaining $427.18 (5/16). Sidecar Customer care agent declined to offer any help in resolving the issue here and I am being asked to pay the outstanding $150 to Sidecar.
Response from Sidecar HealthJun 12, 2025
We’re really sorry for the confusion and frustration around your reimbursement for preventive care at Southeast Medical Group. That’s not the experience we want our members to have. Our member care team will reach out today to walk through your claim, clarify your coverage, and help make things right. We’re committed to resolving this quickly and making sure you feel supported every step of the way. Thanks for flagging this for us. We’re on it.


