Direct Connection to Summit Health
We support direct connections between our offices, provider offices and health systems. The transaction standard is the 837 Professional Claim or 837 Institutional Claim required by HIPAA Administrative Simplification. For help with Summit Health EDI transactions, either contact us or send an email.
Claims Clearinghouses
Below are claims clearinghouses we use: Availability 12400 Coit Rd. #700 / Dallas, TX 75251 / 800-282-4548 / Payor ID = 13350 Change Healthcare (formerly Emdeon) (both medical and hospital) 3055 Lebanon Pik / Nashville, TN 37214 / (615) 932-3000 / Payor ID = 13350 MCPS Inc 1740 S. Glenstone #B / Springfield, MO 65804 / 417-890-6164 MD On-Line Inc. ...
Who is summit administration services?
Summit can assist with finding Best In Class Stop-Loss Insurance, PBMs, Utilization & Review, and Network Vendors. Based in Scottsdale, Arizona, Summit Administration Services, Inc. is a fully licensed third party claims administrator for self-funded employee health benefit programs, workers’ compensation, auto, property and liability coverage.
How do I contact Summit Community Care?
Members have the right to receive assistance through a TTY/TDD line. Summit Community Care can help you telephonically communicate with members with impaired hearing via a translation device. Call the Member Services using the TTY relay service at 711. In-office sign language assistance is also available.
What types of claims can Summit Community Care request additional information?
The following are permissible categories of disputed claims for which Summit Community Care may request additional information: ? If there is no authorization or there was a prior authorization and Summit Community Care disputes the claim consistent with the Summit Community Care basis for denial or because the claim is for services provided ou...
How long does it take Summit Community Care to verify a claim?
Summit Community Care will maintain a written or electronic record of the date of the receipt of a claim. If a provider requests verification, Summit Community Care will provide verification of the date of claim receipt within five working days.
Summit Administration Services Inc. is the CLAIMS