Know Your Benefits
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 Oregon 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. 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.
The list below represents those insurance carriers we most commonly bill on behalf of our patients. This list is subject to change and may not include all insurance or networks we bill. Contracting with an insurance company does not guarantee coverage or payment. Patient deductibles, co-insurance, co-pays, and non-covered services are the responsibility of the patient and are due at time of service.
Our billing team is available by phone at 541-317-4200 to assist when needed.
Insurance and Networks Accepted Include:
- Auto Insurance Carriers
- First Choice Health
- Moda Health
- PacificSource Health Plans
- Providence Health Plans
- Providence Preferred
- Regence BlueCross BlueShield of Oregon
- United Healthcare
- Workers Compensation
We also participate with TriCare and TriWest as a referral source for our local agencies.
Summit Medical Group Oregon accepts Medicare, Medicare Advantage and all supplemental Medicare plans. Because Medicare changes frequently, it’s helpful to visit the Medicare website for the most up-to-date information.
Summit Medical Group Oregon is a participating provider with Medicare. We have a contract with Medicare to provide services to entitled beneficiaries. Medicare patients will be billed only for deductibles, co-pays and non-covered charges.
As a participating Medicare provider, we are required to screen Medicare patients according to the Medicare Secondary Payor (MSP) rules. At each visit, Summit Medical Group Oregon representatives will ask you the MSP questions. These questions will help to confirm if Medicare or another payer should process the claim as the primary insurance.
This may add some time to the check-in process; we apologize for any inconvenience and appreciate your understanding.
Medicare supplemental insurance
If you have additional insurance coverage in addition to Medicare, Summit Medical Group Oregon will bill your supplemental insurance company for any amounts Medicare does not pay. Medicare supplemental and retirement plans may not cover the entire balances after Medicare. Amounts not paid by Medicare or other insurance will be your responsibility.
Medicare as a secondary insurance
Medicare will not cover you for your primary insurance if:
- You or your spouse are still working and is covered by an employee group health plan
- Your were involved in an automobile accident
- You were injured and some other party may be liable for the injury. This includes Workers’ Compensation claims for Medicare insured persons who are still working
In these cases, please provide information regarding the employer group insurance, automobile coverage, or the Workers’ Compensation claim. A Medicare claim will be submitted for any balance the primary insurance does not pay.
We know billing can be confusing and we want to help make it clear for you. We would be happy to answer any additional questions. Please call the Billing Customer Service Department at (541) 317-4200 between the hours of 8a.m. and 5p.m. The Customer Service or Member Service Department from your insurance may also be able to answer specific questions for you. Often their phone number is printed on the identification card provided to you.