Complaint Review: Summit Medical Group

Avoid Summit Medical Group if you don't want a surprise bill that is not covered by your insurance.

I went to Summit Medical Group Urgent Care Center.  They are a participating provider in my insurance plan and I am only supposed to be responsible for a $20 co-pay.  The doctor ordered various lab tests.  My Patient Care Summary said all the lab tests would be performed by "SMG lab".  I was surprised to find out that I am responsible for a lab bill for $434 becuase Summit Medical Group sent some lab tests to Overlook Hospital's lab (which is not a participating provider in my insurance).

I called Summit Medical Group's billing department.  They are "sorry" but it is not their responsibility to send lab tests to a participating laboratory.  What?  All they can say is I am "unfortunately" responsible for the bill to Overlook Hospital's lab.

(1) There was no reason to send some lab tests (the most expensive one that was ordered 2 times) to another lab.  The Patient Care Summary provided to me says all the lab tests would be processed by SMG Lab.  All the laboratory tests processed by SMG lab would have been covered by my insurance company.

(2) Summit Medical Group cannot provide me with the lab results allegedly processed by Overlook.  The manager in billing (Michelle) said the lab results are at Overlook.  So why did they order these lab tests if no one at Summit Medical Group would review the lab results?  Was it really necessary to order lab tests, send it to another facility, and then not even obtain a copy of the lab test results?   

(3) Michelle also said it's not Summit Medical Group's repsonsibilty to ask me which laboratries are participating in my plan because most people don't know.  I happen to know which laboratories participate in my plan.  Even if I didn't know, I could look it up on my smartphone. 

The Summit Medical Group employees just parrot a standard answer.  Basically, they are sorry that I am unfortunately facing a $434 bill to Overlook but they provided me with the best care possible.  No one can provide me with answers to my questions.  Why couldn't SMG lab process the blood tests as indicated on my Patient Care Summary?  Why did they send it to Overlook Hospital's lab if I was only in Summit Medical Group for a few hours?  Why don't they have the lab results from the Overlook Hospital lab?

I went to Summit Medical Group's Urgent Care Center so I would not have a large out-of-pocket expense.  Now through no fault of mine, I owe Overlook Hospital $434.  I didn't seek services from Overlook Hospital.  If I wanted to choose Overlook Hospital, I woud have gone to Overlook's ER instead of waiting for Summit Medical Group's Urgent Care Facility to open at 7:00 am when I was in terrible discomfort and pain!