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Summit Medical Center
University Medical Center

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Summit Primary Care
3939 Central Pike
Hermitage, TN 37076
PHONE: (615) 883-2331
FAX: (615) 391-1785

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Summit Primary Care

Superior Care for the Entire Family:
Infants to Seniors

 

Referral Request Process

We advise you to first check your benefits book or call your insurance company to determine their current rules regarding referrals. Depending on your insurance, many types of specialist visits require a referral approval from your insurance company. If you know or believe that you need a referral from your PCP, please call our main number (615-883-2331) to schedule a referral request evaluation visit with your Physician.

Referral Authorizations

Patients who are in a managed care plan requiring referral authorizations must request it at least 3 days before a visit to a specialist or within 48 hours after an ER or Urgent Care visit. If you fail to do this it may result in you being responsible for payment to the Specialist or the ER. You are responsible for being aware of your own insurance plan requirements for advance referral authorizations. After approval, we will advise you to schedule your appointment with the specialist after we inform them that you are approved for a visit.

If you need an insurance authorization, we will submit a request for a referral authorization number from your insurance company. If it is denied by your insurance, we will contact you and explain their decision. Please be aware that the insurance companies reserve the right to take up to 3 business days to respond to specialist or testing referral requests.

Note: In most cases, even if your insurance does not require a referral authorization for you to see a specialist, we will require that you first schedule an office visit here to allow your Dr. to evaluate you and make sure that you actually need to see a specialist or have special testing done.

Scheduling Specialist Appointments

If we are required by your insurance to schedule your appointment, we will notify you of your appointment date and time by telephone or e-mail. We will generally not schedule specialist appointments for you if you are permitted to do so by your insurance company's rules. In those cases, we will advise both you and the specialist's office of the approved referral, and you will then make your own appointment with the specialist.