Provider news
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.
Important notice for providers billing H0019, H2016, and H2017
Summit Community Care identified an issue impacting claims payments with billing codes H0019 (therapeutic communities), H2016 (community support services), and H2017 (psychological rehabilitation services and life skills).
Voluntary recall of Philips Respironics CPAP machine, BiPAP machine, and ventilators
On June 14, 2021, Philips Respironics* issued a voluntary recall on specific brands of their continuous positive airway pressure (CPAP) machines, bilevel positive airway pressure (BiPAP) machines, and ventilators.
In Pursuit of Racial Equity: Deconstructing Bias
Please join us on June 9th to hear from a diverse panel of experienced professionals about racial equity and implicit bias.
Specialty Pharmacy Prior Authorization Retraction Notice
Notification that effective May 1, 2021 specific codes would be included in our prior authorization review process.
Infusion Step Therapy Retraction Notice
Notification that effective May 1, 2021 specific codes would be included in our step therapy review process.
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Pharmacy information
Search for up-to-date drug information, including hundreds of brand-name and generic medications.
Maternal Child Program
When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. We encourage all our moms-to-be to take part in the Taking Care of Baby and Me® program, a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.
Behavioral health providers
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.