Summit Community Care

Providers

Pharmacy Information and Tools


We will administer pharmacy benefits for enrolled members. Express Scripts, Inc. (ESI) is the pharmacy benefits manager.

Medicaid

Please refer to the Preferred Drug List (PDL) when prescribing for our members. This guide does not contain a complete list of drugs; rather, it lists the preferred drugs within the most commonly prescribed therapeutic categories.

Though most medications on the PDL are covered without prior authorization, a few agents will require you to contact our Pharmacy Department for authorization.

Authorizations online:

To request or check the status of a prior authorization request or decision, please log in to the Availity Portal.

Don't have an Availity account? Register for free now!

Need help with Availity?  Learn more.

Authorizations by phone:

Call — 1-844-462-0022
Hours — 8 a.m.-8 p.m. (Eastern time) Monday-Friday
              10 a.m.-2 p.m. (Eastern time) Saturday

Authorizations by fax:

Retail Prior Authorization — 1-844-429-7761
Medical Injectables — 1-844-429-7762

Related information

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.