Member FAQs

General Questions

SmartHealth provides dedicated, personalized support designed to help members better manage their healthcare costs. We pay providers directly and promptly for services delivered to our members.

With same-day payment available upon request and $0 deductibles for members, SmartHealth creates a faster, simpler billing experience for everyone involved.

You can contact the Concierge at any time for:

Questions about your benefits
Help during a clinic or hospital visit
Billing concerns
Prescription assistance
Provider questions

If you experience an issue during an appointment, call (877) 763-4955 for real-time support.

SmartHealth covers services eligible under your employer’s major medical plan.

If your primary health plan covers the service, SmartHealth will cover it as well. Some employers may elect to include additional benefits.

Refer to your benefits guide for specific coverage details.

Yes.

SmartHealth works with providers who accept direct payment or cash-based transactions. This includes most clinics and physicians.

If a provider has questions, our Concierge team will assist them.

Your cost depends on your specific plan design.

For most copay plans, members typically have:

$0 copay
$0 deductible

Please review your benefits guide for your exact plan details.

SmartHealth negotiates directly with providers to secure meaningful cost savings.

A portion of those savings is passed on to members in the form of reduced out-of-pocket costs.

Yes.

Hospitals accept SmartHealth and often receive competitive reimbursement through our direct payment model.

If you experience any issues, contact the Concierge immediately.

For Tier 1–3 prescriptions, use the pharmacy benefit information on your member card.

For Tier 4 or specialty medications, contact the Concierge. We will coordinate support and help you access your medication.

You can access your card through the online member portal.

If you need assistance, call the Concierge at (877) 763-4955.

Appointment & Pre-Registration Questions

If asked to pre-register before your appointment:

Select “Self-Pay” or “Cash Pay” when asked about insurance. Even though SmartHealth is insurance, it is managed outside traditional insurance systems, so your member ID will not appear in the provider’s system.
Do not enter SmartHealth ID numbers in the insurance section. These numbers are for internal billing only.
At your appointment, remind office staff this is a cash transaction and that SmartHealth pays providers directly.
Ensure the bill is sent to SmartHealth using the billing information listed on your member card.

No.

Simply present your SmartHealth card at your appointment. If any questions arise, the Concierge team is available to assist.

Post Appointment FAQs

Call the SmartHealth Concierge immediately at (877) 763-4955.

Our team will contact the provider directly and explain how SmartHealth works. We handle these situations quickly and professionally.

This can occasionally happen. You have two options:

Call the Concierge while you are still at the office. We can often resolve the issue in real time so you don’t have to pay.
If you choose to pay, SmartHealth will reimburse you for eligible services.

HSA Plan Questions

If you are enrolled in the HSA plan, it is typically easiest to pay with your HSA card at the time of service.

You will pay the cash price for services until you meet your $1,700 individual deductible.

Once your deductible is met, your $0 copay and $0 deductible benefits apply for covered services.

Refer to your benefits guide for family deductible amounts.

If you are enrolled in the HSA plan:

Federal law requires you to satisfy a $1,700 individual deductible before benefits begin.
You are responsible for eligible expenses up to that amount.
Once the deductible is met, SmartHealth benefits apply — typically with $0 copay and $0 deductible for covered services.

Refer to your benefits guide for family deductible amounts.

Yes.

After paying at the provider’s office, submit your receipt to SmartHealth so we can:

Apply the payment toward your $1,700 deductible
Track when your deductible has been satisfied

Receipts can be submitted using the contact information listed on your SmartHealth card.