Summit Community Care

Providers

Welcome, providers!

On this site, you will find resources that help health care professionals do what they do best — care for our members.

Are you interested in joining our network? We look forward to working with you to provide quality services to our members.

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.

Billing update for physical, occupational, and speech therapy providers

Summit Community Care is a joint venture formed between the Arkansas Provider Coalition, LLC and Anthem Partnership Holding Company, LLC, a wholly owned subsidiary of Anthem, Inc. The health plan is live as of March 1, 2019. Previously, the state of Arkansas required physical, occupational and speech therapy providers bill with CPT codes deactivated by CMS/CPT in January 2017.

Ninety-day continuity of care period for behavioral health authorizations

For the March 1, 2019, implementation of the Provider-Led Arkansas Shared Savings Entity (PASSE) program, Summit Community Care will observe a 90-day period of continuity of care for all members with existing behavioral health authorizations. No service will be denied for circumstances where authorizations were in place and authorized by the Arkansas Department of Human Services prior to March 1, 2019.

Clinical Criteria Updates - Posted 3/7/2019

On August 17, 2018, October 9, 2018, and November 16, 2018, the pharmacy and therapeutic (P&T) committee approved the following Clinical Criteria applicable to the medical drug benefit for Summit Community Care. These policies were developed, revised and/or reviewed to support clinical coding edits.

120-day Continuity of Care Waiver for Community and Employment Services Waiver members

For the March 1, 2019, implementation of the PASSE program in Arkansas, Summit Community Care is adopting a 120-day Continuity of Care Waiver for all members in the Community and Employment Services (CES) Waiver Program. No service will be denied for absence of authorization where waiver services were in place and authorized by the Arkansas Department of Human Services prior to implementation. Rates/payments established within the current waivers will be paid by Summit Community Care through the 120-day period.

Availity access


At Availity you can:

Request Authorizations
Submit Claims
Confirm Eligibility

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Featured resources


Pharmacist looking at prescription bottle

Pharmacy information

Search for up-to-date drug information, including hundreds of brand-name and generic medications.

Expectant mother sharing ultrasound

Maternal Child Program

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.

Caring therapist counseling patient

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.

Provider tools & resources

Interested in becoming a provider in the Summit Community Care Network?

We look forward to working with you to provide quality service for our members.