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.