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Claims Processing Policies

If a provider office prefers take backs be done on all overpaid claims, a signed letter on office letterhead agreeing to take backs across the board should be submitted to SummaCare. This would apply to all overpayments pending and in the future. Providers are not notified in advance of the take back.

A refund request letter will be sent in the event the overpayment is not recouped within 90 days.

Please send the above mentioned letter of agreement to:
SummaCare Insurance Company
Attention: Recovery
1200 East Market Street, Suite 400
Akron OH 44305

Beginning October 1, 2020, paper overpayment requests for providers who have not agreed to take backs will be sent once. Overpayments not refunded within 30 days, will be recouped from future claims.

Any questions regarding the take back process should be directed to Provider Support Services at 330.996.8400 or 800.996.8401. Providers may also email questions to

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Provider Support Services

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Provider Engagement Specialists

If you have not met with your assigned Provider Engagement Specialist or would like to schedule an in-office training or meeting to address any questions regarding the authorization process, claims issues, appeals, SummaCare products/benefits or Plan Central training, please contact the assigned Provider Engagement Specialist for your office.

Plan Central

View patient eligibility, benefits, claims status, and self-funded prior authorization lists, as well as review clinical edits and clarifications.