Here you will find the latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription information, and more.
At this time, enrollment for electronic funds transfer (EFT) through CAQH EnrollHub is unavailable. When this feature is available, we will provide an update.
On September 19, 2019, the Pharmacy and Therapeutics (P&T) Committee approved the following Clinical Criteria applicable to the medical drug benefit for Anthem Blue Cross. These policies were developed, revised or reviewed to support clinical coding edits.
Effective November 1, 2019, prior authorization (PA) requirements will change. These services will require PA by Summit Community Care for Medicaid members
We are in the process of updating the Summit Community Care provider manual to include information on how providers can submit claim payment disputes through the Availity Portal, as well as some additional information on the process.
If you don't have an Availity account, you can register for free now!
Search for up-to-date drug information, including hundreds of brand-name and generic medications.
We offer a proactive case management program for expectant mothers and their newborns. The My Advocate™ program provides pregnant women proactive outreach and education through Interactive Voice Response (IVR), text or smartphone application.
We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts, and other resources to successfully meet the needs of members with behavioral health and substance use needs, as well as those with intellectual and developmental disabilities.