Health plans and insurers

SummaCare

Phone, published email, fax, addresses and the next step for your office.

18 contact routesNo directory research calls placed

provider services

SummaCare Provider Support Services

Official page read

Phone800-996-8401Published email

contactproviderservices@summacare.com

Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

General provider support and routing (eligibility, claims questions, failed uploads); local 330-996-8400 (TTY 711). Plan Central portal for eligibility, benefits and claim status.

View source ↗ · Source checked 2026-10-25 · Claims page: Provider Support Services phones ↗

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

claims

SummaCare paper claims and payer IDs

Official page read

Phone330-996-8400Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

SummaCare PO Box 3620 Akron, Ohio 44309

Paper claims

Timely filing 365 days from DOS. Electronic payer IDs: 95202 (SummaCare), 34196 (Apex Health Solutions). Bill Medicare Advantage as Traditional Medicare. No dispute process for code-edit inquiries.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

prior authorization

SummaCare utilization management prior authorization

Official page read

Phone888-996-8710

Urgent/expedited authorization requests (local 330-996-8710)

Fax

330-996-8992

Routine authorization requests (Authorization Request Form for Service), including after hours

Published hours

Mon-Fri 8:30am-5pm

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

Routine PA and admission authorizations by fax or GuidingCare portal; urgent requests by phone.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

prior authorization

SummaCare weekend/holiday urgent, nursing home and inter-facility transfer authorizations

Official page read

Phone330-414-1653Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

Weekends and holidays only: urgent/expedited requests, nursing home authorizations and inter-facility transfers.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

prior authorization

SummaCare after-hours emergency admission authorization (24-hour nurse line)

Official page read

Phone800-379-5001Published hours

24/7

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

After-hours authorization for emergency hospital admissions.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

prior authorization

SummaCare eviCore (high-tech radiology, oncology, radiation therapy, genetic testing)

Official page read

Phone855-774-1315Fax

800-542-2406

Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

eviCore reviews medical necessity for SummaCare high-tech radiology, medical oncology, radiation therapy and genetic lab tests.

View source ↗ · Source checked 2026-10-25 · Manual: eviCore contact for SummaCare accounts ↗

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

appeals grievances

SummaCare appeals and grievances

Official page read

Phone330-996-8480Fax

330-996-8545

Published email

appeals@summacare.com

Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

SummaCare ATTN: Appeals & Grievances PO Box 1107 Akron, OH 44309-1107

Appeals and grievances

Pre-service and post-service appeals in writing (fax, mail, email, in person); expedited pre-service appeals accepted verbally by phone.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

edi clearinghouse support

SummaCare EDI support

Official page read

Phone

No phone listed for this route

Fax

330-996-8877

Published email

EDISupport@SummaCare.com

Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

SummaCare Attn: EDI Support PO Box 3620 Akron, OH 44309-3620

HIPAA transaction forms

HIPAA transaction forms, trading partner setup, EFT/ERA questions; Apex Health Solutions EDI support uses the same P.O. Box and fax. Payer IDs 95202 / 34196.

View source ↗ · Source checked 2026-10-25

Report an update

provider enrollment credentialing

SummaCare provider engagement specialists

Official page read

Phone

No phone listed for this route

Fax

330-996-8490

Published email

providerengagement@summacare.com

Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

SummaCare PO Box 3620 Akron, Ohio 44309-3620

Provider engagement correspondence

Office training, orientation, Plan Central training, complex claims, authorization portal and contracting questions.

View source ↗ · Source checked 2026-10-25 · Manual: provider engagement email ↗

Report an update

email other

SummaCare contracting / directory listing corrections

Official page read

Phone

No phone listed for this route

Published email

sccontracting@summacare.com

Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

Notify SummaCare when online provider directory listing information is incorrect.

View source ↗ · Source checked 2026-10-25

Report an update

case management

SummaCare Health Services Management referrals

Official page read

Phone877-888-1164Published email

CaseManagement@SummaCare.com

Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

Health services / case management program referrals; local 330-996-8931.

View source ↗ · Source checked 2026-10-25 · Manual: case management email ↗

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

case management

SummaCare home-based palliative care referrals (CareCentrix)

Official page read

Phone234-867-7015Published email

palliativereferrals@carecentrix.com

Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

CareCentrix Enhanced Support direct referrals for seriously ill members.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

provider services

SummaCare DME and O&P (HOMELINK)

Official page read

Phone844-358-2549Fax

844-582-3858

Published email

HomelinkSummaCare@vgm.com

Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

HOMELINK DME/O&P requests, order status and supply reorders, including preferred diabetes testing supplies.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

pharmacy help desk

SummaCare specialty pharmacy (AcariaHealth)

Official page read

Phone855-422-2742Published hours

Not published in this record

Product, plan and location

commercial · exchange
Ohio

Mailing address

Not researched for this route

Specialty pharmacy for most commercial and all marketplace members; alternate 833-626-8417.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

fax other

SummaCare compliance hotline

Official page read

Phone800-361-3908Published email

compliance@summacare.com

Published hours

24/7

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

SummaCare Compliance Officer PO Box 3620 Akron, OH 44309-3620

Compliance reports

Compliance/FWA reporting; local 330-996-8821.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

claims

SummaCare subrogation / third-party liability vendor (Optum)

Official page read

Phone800-418-6966Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

Subrogation/TPL vendor listed on the SummaCare vendors page.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

claims

SummaCare No Surprises Act (Zelis)

Official page read

Phone888-266-3035Published hours

Not published in this record

Product, plan and location

medicare advantage · commercial · exchange
Ohio

Mailing address

Not researched for this route

Zelis handles No Surprises Act matters for SummaCare.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

member services

SummaCare Medicare member services (member line)

Official page read

Phone800-996-6250TTY phone800-750-0750Published hours

Not published in this record

Product, plan and location

medicare advantage
Ohio

Mailing address

Not researched for this route

Member-facing; local 330-996-8885. Individual/employer members without ID card: 833-443-0818.

View source ↗ · Source checked 2026-10-25

Report an update

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

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SummaCare

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