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.
For the past several months, Summit Community Care worked closely with key leaders and stakeholders to develop a new payment structure for the Community and Employment Services (CES) Waiver Program since there is no established fee schedule under Medicaid. Accompanying this update, you will find a full waiver grid that defines all services, unit definitions and rates.
Effective November 1, 2019, prior authorization (PA) requirements will change. These services will require PA by Summit Community Care for Medicaid members
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.