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 and accept assignment of all Medicare claims. We also participate with a number of Medicare Advantage plans. (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, 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
Beech Street	Beech Street
BlueCross BlueShield of Tennessee	Blue Network C (formerly "BlueClassic"), Blue Network P (formerly "Blue Preferred")
Cariten	Cariten Select, Cariten Choice, Cariten Preferred, Cariten HMO, Cariten TPA Services, PHP Leased, First Sevier
CIGNA	CIGNA Preferred Provider Access, CIGNA Access Plus, CIGNA HMO, CIGNA POS, CIGNA POS Open Access, CIGNA PPO, CIGNA EPO, CIGNA TrueAccess/EPO
First Health	First Health, Coventry Health plan, Mailhandlers Benefit Plan-Coventry Health plan
Great West	One Health
Humana	ChoiceCare
The Initial Group	The Initial Group
United Healthcare of the River Valley (formerly John Deere)	Heritage Choice, Heritage Select
One Health	One Health Plan
Private Healthcare Systems	Private Healthcare Systems (PHCS)
TriCare (formerly Champus)	TriCare Standard, TriCare-for-Life
United Healthcare	United Healthcare PPO, United Healthcare HMO, United Healthcare POS, United Healthcare Select Plus, United Healthcare AARP
USA MCO	USA Select, USA Select Accountable Alliance

Medicare:

Medicare BlueCross BlueShield of Tennessee	Original Medicare Program BlueAdvantage PPO Diamond, BlueAdvantage PPO Sapphire
Cariten Senior Health	Cariten Senior Health Advantage, Cariten Senior Health Advantage Plus, Cariten Senior Health Advantage Elite, Cariten Senior Health Value, Cariten Senior Health Value Plus, Cariten Senior Health Value Elite, Cariten Senior Health PPO
Humana	Humana Gold Choice PFFS (HMO), Humana Choice PPO
Secure Horizons of United Healthcare* (Formerly John Deere Secure Plus) *Existing Summit Medical Group patients who were enrolled with Secure Horizons prior to October, 2007.	*Secure Horizons Medicare Complete Plan 1, *Secure Horizons Medicare Complete Plus 15, *Secure Horizons Medicare Complete Essential and *Secure Horizons Medicare Complete Plus Prime *All Plans - Existing Summit Medical Group patients who were enrolled with Secure Horizons prior to October, 2007.
AmeriChoice Secure Plus Complete	AmeriChoice Secure Plus Complete

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 Summit Does Not Participate In:

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
Sterling	Sterling Option I and Sterling Option II
Secure Horizons Medicare Direct by United Healthcare (formerly Pacificare)	Secure Horizons Medicare Direct Plan 3 and Secure Horizons Medicare Direct Plan 3A
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

NPI INFORMATION:

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

To access secure NPI Information, click here.

CONFIDENTIALITY & PRIVILEGE NOTICE

This electronic transmission and any documents accompanying this electronic transmission contain confidential information belonging to the sender. This information may be legally privileged. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on or regarding the contents of this electronically transmitted information is strictly prohibited.