Billing
& Insurance
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 |
Original Medicare Program |
|
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, Cariten Senior Health Balance and
Cariten Senior Health Complete
|
|
Humana |
Humana Gold Choice PFFS (HMO) |
Secure Horizons of United Healthcare*
(Formerly John Deere Secure Plus)
*Existing Secure Horizons of United Healthcare Patients
Only
|
*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 Secure Horizons of United Healthcare
Patients Only |
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"),
Blue Network K |
Medicare
Plans Summit Does Not Participate In:
|
Advantra Freedom |
Freedom 1 and Freedom 2 |
| 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 and CIGNA Medicare Access Plus RX |
|
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 10 |
|
BCBS Medicare Advantage |
BCBS Blue Advantage, BCBS Blue Advantage Choice, BCBS Blue
Advantage Gold, BCBS Blue Advantage 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 Comprehensive, Windsor Medicare Extra TN Choice and Windsor Medicare Extra TN Choice + RX |
Other
Plans Summit Does Not Participate In:
NPI
INFORMATION:
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.
|