Medicare | Managed Care | Patient Billing Statement | Patient's Responsibility |
Payment Policy | Insurance Plans Accepted

It is Summit Medical Group's goal to guide our patients through today's complex world of medical billing. Our Central Business Office, located at 1225 E. Weisgarber Road in Knoxville, handles all questions regarding patient billing and insurance. Our Customer Service Department can be reached at (865) 212-3618, Monday through Friday from 8:00 a.m. to 4:00 p.m.

Our office will prepare and file your insurance claim forms for you based on the information you provide to us. To process your claim, it is essential that you provide us with accurate and complete insurance information. It is for this reason that our offices will frequently request updated copies of your insurance card(s) and ask that you complete a new patient registration form.

MEDICARE  top

We are a participating provider with Original Medicare along with the Medicare Advantage plans listed below. (See Link Below). We will file your Medicare claim for you and Medicare will then send the payment directly to Summit. At the same time, a Medicare Explanation of Benefits (EOB) will be mailed to your home address. We will also file supplemental policies on your behalf. Any deductible or co-insurance amount is your responsibility at the time services are rendered.

Please click here to view the Medicare Advantage Plans in which Summit participates.

MANAGED CARE  top

Please inform us at the time your appointment is scheduled if you are in a PPO or HMO managed care plan. Any co-payment required by your insurance plan is due at the time services are rendered. Summit Medical Group participates in many major plans, but because we consider many factors before joining a plan, we do not participate in every plan available on today's insurance market. If we do not participate with your plan, and you choose to see our physicians outside the plan, your benefits may be reduced or eliminated completely. Listed below are some of the managed care plans in which Summit participates. Check with your physician's office if you have further questions.

PATIENT'S RESPONSIBILITY  top

Although Summit gladly files your medical insurance on your behalf, medical insurance is ultimately a contract between the patient and his/her insurance company. It is the patient's responsibility to monitor the processing and payment of claims. After payment is received from the insurance carrier, any outstanding balances will be transferred to a patient responsibility status. If your insurance company is not one with which our physicians participate, any balance remaining on the account for sixty days from the date the insurance is filed becomes the patient's responsibility.

PAYMENT POLICY  top

Payment for all rendered services is requested when you receive a statement indicating a balance due. Insurance payments sent directly to your home address should be forwarded to our Central Business Office as payment for services rendered. We accept cash, check, American Express, Master Card, Visa, or Discover as payment for services rendered.

MAJOR COMMERCIAL AND MEDICARE PLANS SUMMIT DOES PARTICIPATE IN:  top

Commercial Managed Care:

Aetna	Aetna Open Choice, Aetna Traditional Choice, Aetna Managed Choice, Aetna Elect Choice, Aetna PPO, Aetna POS
BlueCross BlueShield of Tennessee	Blue Network P (formerly "Blue Preferred")
CIGNA	CIGNA HMO, CIGNA POS, CIGNA Open Access Plus, CIGNA PPO, CIGNA EPO, CIGNA Network, CIGNA Network POS, Network Open Access, POS Open Access, CIGNA West (formerly Great West) PPO and Open Access, CIGNA Partnership PPO, CIGNA Standard PPO
Humana	Humana HMO, Humana NPOS, Humana PPO
United Healthcare of the River Valley (formerly John Deere)	Heritage Choice, Heritage Select
MultiPlan	PHCS Network, MultiPlan Network
TriCare (formerly Champus)	TriCare Standard, TriCare-for-Life
United Healthcare	United Healthcare PPO, United Healthcare HMO, United Healthcare POS, United Healthcare Select Plus
Other	Beech Street, First Health, Coventry Health Plan and Mailhandlers Benefit Plan, One Health, The Initial Group, USA Select, USA Select Accountable Alliance, Bluegrass Family Health
Attention State of Tennessee Employees: You must select CIGNA coverage because Summit Medical Group does NOT accept BlueCross BlueShield Network S (except in Greene County).

Medicare:

Medicare	Original Medicare Program (Including all supplement plans)
Humana	Humana Gold Plus, Humana Choice

Medicare/TennCare (Special Needs Plan):

United Healthcare	United Healthcare Dual Complete Preferred (formerly AmeriChoice Secure Plus Complete)
Humana	Humana Gold Plus SNP

MAJOR COMMERCIAL AND MEDICARE PLANS SUMMIT DOES NOT PARTICIPATE IN:  top

Commercial Plans Summit Does Not Participate In:

BlueCross BlueShield of Tennessee

Blue Network S (formerly "BlueSelect"), except in Greene County Blue Network K

Medicare Plans No Longer Accepted - As of January 1, 2011:

BlueCross BlueShield of Tennessee

BlueAdvantage Diamond, BlueAdvantage Sapphire, BlueAdvantage Ruby, BlueAdvantage PPO, BlueAdvantage Plus PPO (Medicare Contract Number H7917)

Medicare Plans Summit Does Not Participate In:

AARP	AARP Medicare Complete
Advantra Freedom	Freedom 1, Freedom 2, Freedom 5
Aetna Medicare Advantage	Aetna Medicare Advantage Open Value, Golden Medicare Value, Golden Medicare Standard, Golden Medicare Premier, Medicare Open Plan
CIGNA Medicare Access (Medicare Advantage Private Fee for Service Plan)	CIGNA Medicare Access Plan 1, CIGNA Medicare Access Plan 2, CIGNA Medicare Access Plan 3
Humana	Humana Gold Choice PFFS
Secure Horizons of United Healthcare	All Plans
Sterling	Sterling Option I and Sterling Option II
BCBS Medicare Advantage	BCBS Blue Advantage, BCBS Blue Advantage PFFS Silver, BCBS Blue Advantage PFFS Gold, BCBS Blue Advantage PFFS Platinum, BCBS Blue Advantage Complete
Pyramid Life Insurance	Today's Options Premier Plus and Today's Options Value Plus
Windsor Health, Inc.	Windsor Medicare Extra Silver, Windsor Medicare Extra Gold, Windsor Medicare Extra Platinum, Windsor Medicare Extra Special Care Fusion, Windsor Medicare Extra Special Care Fusion Plus

Other Plans Summit Does Not Participate In:

Lab one	Lab Card Program
Quest Lab	Quest Lab Program

NPI INFORMATION:

To request NPI Information access, contact us at npi@summithealthcare.com.

To access secure NPI Information, click here.

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