Provider Resources
Provider FAQs
Who do I contact about billing?
For billing questions, call provider services at 1-800-282-7644.
Can I sign up for electronic payments?
Summit-managed carriers offer ACH electronic payments for a fast, convenient and secure method of medical provider invoice payments. This service is provided through Zelis Payments, a third-party vendor who will facilitate making the deposit directly into your bank account.
To sign up for electronic payments, visit zelispayments.com, email [email protected] or call Zelis Payments membership department at 1-877-828-8834.
If you are already enrolled to receive electronic payments via Zelis Payments from another health-care payor, you will automatically be enrolled to receive payments from Summit-managed insurance carriers.
What are my billing options?
Electronic
Medical providers can submit bills directly to Summit through our electronic billing system. For more information, contact Jopari Solutions at 866-269-0554 or [email protected].
Mail
To submit bills via mail, select the address appropriate for your state:
Florida:
P.O. Box 2928
Lakeland, FL 33806
Southeast Region (Georgia, Illinois, Indiana, Kentucky, North Carolina, South Carolina, Tennessee, Virginia):
P.O. Box 600
Gainesville, GA 30503-0600
Southwest Region (Alabama, Arkansas, Louisiana, Mississippi, Oklahoma, Texas):
P.O. Box 80439
Baton Rouge, LA 70898-0439
Fax
To submit bills via fax: 863-667-1871
How long does it take to receive payment after submitting my bill?
Summit processes medical bills using the mandated time allowances determined by each state. You can expect payment for your bill within the time frame listed (in calendar days from date of receipt/notice, unless stated otherwise).
- Alabama: 25 working/business days
- Arkansas: 30 days
- Florida: 45 days
- Georgia: 30 days
- Illinois: 30 days
- Indiana: 90 days
- Kentucky: 30 days
- Louisiana: 60 days for bills received via mail, 30 days for bills received electronically
- Mississippi: 30 days
- North Carolina: 60 days
- Oklahoma: 45 days
- South Carolina: 30 days
- Tennessee: 30 days
- Texas: 45 days
- Virginia: 60 days
What do I do if I don't agree with the payment amount I receive?
If you feel the payment you have received for a medical bill is incorrect, you may either resubmit the bill for reconsideration or call provider services at 1-800-282-7644.
Why is telemedicine encouraged?
Summit supports and encourages the use of telemedicine and can work with any provider who offers this service. We process these appointments and bills the same as in-office visits. While some injuries require an initial in-person visit to establish a treatment plan, telemedicine is a good option for many follow-up, consultation and physical therapy appointments. Benefits include:
- Providing patients easier access to providers, especially when an injury makes transportation difficult or the patient lives in a remote area
- Allowing you the flexibility to see patients from your home, office or other remote locations, provided you have privacy and a secure internet connection
- Providing another health-care option for injured employees when clinics are forced to close or reschedule appointments
- Providing the opportunity for decreased wait times and a higher level of patient satisfaction
If your practice is considering telemedicine or wants to discuss how it can be used for workers’ compensation appointments, give our network team a call at 1-800-282-7644.
How do I submit billing for telemedicine?
When completing the Health Insurance Claim Form, use 02 for the place of service to indicate telehealth services were provided through a telecommunication system. You will also need to use modifier 95 to designate that telemedicine services were rendered.
What role does a medical provider play in the return-to-work process?
As a physician, your recommendations about the therapeutic value of work are a vital part of rehabilitation. That’s why it’s important to collaborate with your patients’ employers to get their injured employees back on the job as soon as possible. Back2work®, Summit’s return-to-work program, is designed to help you do just that.
The program was created to encourage treating physicians and employers to work together to set up transitional duty for employees as they recover. You decide when the patient can safely return to work in a transitional capacity. Focusing on what the injured employee can do, rather than what they can’t do in your work status reports can help the employer find appropriate modified or alternate work that fits the patient’s current physical capabilities.
For more information, email [email protected].
As a physician, your recommendations about the therapeutic value of work are a vital part of rehabilitation. That’s why it’s important to collaborate with your patients’ employers to get their injured employees back on the job as soon as possible. Back2work®, Summit’s return-to-work program, is designed to help you do just that.
The program was created to encourage treating physicians and employers to work together to set up transitional duty for employees as they recover. You decide when the patient can safely return to work in a transitional capacity. Focusing on what the injured employee can do, rather than what they can’t do in your work status reports can help the employer find appropriate modified or alternate work that fits the patient’s current physical capabilities.
For more information, email [email protected].
Additional Resources
Medical Treatment Guidelines
We use the following resources to guide our medical treatment approval decisions. For more information about how we use these guidelines, or how you can access them, please call your Heritage Summit representative.
Official Disability Guidelines (ODG)
Louisiana Medical Treatment Guidelines
North Carolina Provider Preauthorization Review
If you practice in the state of North Carolina and would like to submit a request for preauthorization review, fill out the form below. Included with the form are a list of guidelines related to preauthorizations in your state. Please be sure to review these carefully.
North Carolina Preauthorization Review Request
If you have a question about a preauthorization review request between 8:00 a.m. and 4:30 p.m. ET, please call 1-800-971-2667, and a preauthorization representative will be happy to assist you.
If you have a question about a preauthorization review request between 4:30 p.m. and 8:00 p.m. ET, please call 1-513-904-7448 and leave your name, telephone number with area code and a brief message. Be sure to include the claim number and injured employee’s name. A representative will return your call promptly, typically within 30 minutes.
Payors
Listed below are all of the workers’ compensation payors who have access to Heritage Summit HealthCare LLC. You may receive payments from any of these entities related to your workers’ compensation patients.
- Bridgefield Casualty Insurance Company
- Bridgefield Employers Insurance Company
- Bridgefield Indemnity Insurance Company
- BusinessFirst Insurance Company
- RetailFirst Insurance Company
- Retailers Casualty Insurance Company
Florida Physician Dispensed Prior Authorization Review Process
Florida physician-dispensed medications must be authorized prior to dispensing, under the Florida workers’ compensation laws. For authorization, you must provide acceptable medical necessity information.
To obtain prior authorization please call 863-262-4400 between 8:00 a.m. and 4:30 p.m. ET, and a preauthorization representative will be happy to assist you.
Please specify the drug name, dosage, and strength. This ensures timely authorization and payment in compliance with Fla. Admin. Code Ann. r. 69L-7.730(2)(l)(1)(b) (2025).
After preauthorization is obtained, third party physician billing entities should send physician dispensed medication bills via one of the following:
- Email: [email protected]
- Fax: 863-667-1871
- Mailing address: P.O. Box 2928, Lakeland, FL 33806-2928
- Jopari (Electronic Submission): Providers can submit bills directly to Summit through our electronic billing system with Jopari. For more information, contact Jopari Solutions at 866-269-0554 or [email protected].
FL WC Rule Reference – Fla. Admin. Code Ann. r. 69L-7.730(2)(l)(1)(b) (2025):
(2) Special Billing Requirements.
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(l) Pharmaceutical(s), Durable Medical Equipment and Home Medical Equipment or Supplies.
1. When dispensing commercially available medicinal drugs commonly known as legend or prescription drugs:
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b. Physicians (including oral surgeons), physician assistants, ARNPs, and any other recognized practitioners registered to dispense medications pursuant to section 465.0276, F.S., may dispense medications to the injured worker. Medication is treatment and must be authorized prior to dispensing, pursuant to section 440.13(3)(a), F.S., and must be medically necessary to treat the compensable injury. Dispensing such medication may not be denied, absent a contrary contractual provision, and reimbursement may not be disallowed or adjusted for the sole reason that the injured worker has chosen to receive such medication from a practitioner registered to dispense medications under Chapter 465, F.S. All requests for authorization of medications to be dispensed must specify drug name, dosage, and strength, must be documented in the injured worker’s file, and must be sent in a manner prescribed by the carrier pursuant to section 440.13(3)(e), F.S. A carrier’s failure to timely respond to a written request for authorization shall be governed by section 440.13(3)(d), F.S.F.S. A carrier’s failure to timely respond to a written request for authorization shall be governed by section 440.13(3)(d), F.S.