Insurance

 

 

Summit Medical Group participates in Horizon Medicare Advantage plans
and provides services in network
for Blue Plans that participate in the BlueCard program,
(this includes patients covered by Empire BCBS and Anthem BCBS,
but excludes managed Medicaid under Horizon NJ Health)
at our Essex, Morris, and Somerset county sites.
 
 

Now more than ever, ongoing changes with health insurance plans make it especially important to understand your coverage and know the costs you must pay when visiting your physician, having tests, and undergoing procedures. For this reason, Summit Medical Group recommends that you learn the specifics of your plan before upcoming health care visits.

Your insurance plan may require multiple copays, higher deductibles, and coinsurance. Coverage will depend on the type of plan you have chosen.

Summit Medical Group participates in a variety of health plans. For this reason, we have developed a billing process that accepts benefits from participating plans.

You can learn the details of your policy by visiting your insurance company’s Web site or contacting its customer/member services department. The back of your insurance card should include the phone numbers and Web site addresses you’ll need.

Questions to ask your insurer:

  • Is my doctor's visit covered completely? If not, how much will I be expected to pay?
  • If I need tests, will they be covered completely? If not, how much will I be expected to pay?
  • If I need a procedure, including surgery, how much will my insurance cover? How much will I be expected to pay?
  • Will I need authorization before my health care visit?
     

Summit Medical Group accounts representatives and financial counselors
can answer billing questions Monday through Friday
9:30 AM to 4:30 PM.

Call us at 908-790-6500
or email us at billing@smgnj.com.

 

Please click here for information on Workman's Compensation and Personal Injury Protection.

Summit Medical Group is in network with these plans:

 

About Insurance Exchanges

Out-of-network Coverage
If your health insurance plan does not appear on the list above, you may still be seen by a Summit Medical Group provider; however, you must:

  • Use your out-of-network benefits
  • Pay for your services in full when you receive them
  • Complete the claim form
  • Ask your insurance company to reimburse you

Summit Medical Group is not in network with:

  • Oxford Liberty Plan, except for select providers. Please see Oxford Liberty listing above.
  • Medicare Advantage Plans, except Aetna Medicare Advantage and Horizon Medicare Advantage plans
  • AmeriHealth® Value Network

Patient Portal

  • Pay bills and manage accounts
  • Access lab And test results
  • Request a refill
  • Email your doctor's office
  • Email an appointment request