SummaCare
Also covers / subsidiaries: SummaCare Inc.
Core Payer & Clearinghouse Profile
Electronic Payer ID
95202
95202 for fully-funded plans; 34916 for self-funded plans. Verify the correct ID for the member plan.
Timely Filing Limit (TFL)
Varies — confirm via portal / clearinghouse
Appeal Window
Varies — confirm via portal / clearinghouse
Clearinghouse Gateway
Availity
Provider Services
800-996-8401
Claims Fax
330-996-8545
Claims Address
SummaCare, PO Box 3620, Akron, OH 44309-3620
Provider Portal
https://summacare.myplancentral.com/
Ohio-based commercial/Medicare Advantage plan; self-funded vs fully-funded use different payer IDs. As of Mar 4, 2026 disputes go through Plan Central.
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for SummaCare.
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under SummaCare.
| Clearinghouse Name | Electronic Payer ID | Status | Enrollment | Supported Services |
|---|---|---|---|---|
| Summa Management Services Organization (Smso) / Summacare | 95202 | Non-Par | None | 837P837I835 ERA |
| Summacare Health Plan | 95202 | Par | None | 837P837I835 ERA |
Resolution Tools for SummaCare Claims
Values vary by plan, line of business, and provider agreement. Confirm in the payer portal or with your clearinghouse gateway before submitting electronic claims.
Tired of Chasing SummaCare Denials & Delayed Payments?
Aethera's billing specialists work SummaCare every day — handling EDI clearinghouse rejects, prior authorizations, payment posting, and 30-day AR aging recovery.