How do I contact Summit Community Care Member Services?
If members/caregivers need assistance with filling prescriptions or appointment scheduling, encourage them to contact Summit Community Care Member Services at 844-462-0022(TTY 711) for assistance. Diversion plans
Are home health services covered by Summit Community Care?
Home health services are covered when the member’s PP or attending provider certifies the services are medically necessary on a part-time, intermittent basis by a member who requires home visits. Prior authorization is required for coverage of procedures and services. Summit Community Care may choose.
What does Summit Community Care require in its medical records?
Member records Summit Community Care requires medical records to be maintained in a manner that is current, detailed and organized and permits effective and confidential patient care and quality review. Providers are required to maintain medical records that conform to good professional medical practice and appropriate health management.
What is Summit Community Care’s billing code policy?
Summit Community Care will reject claims submitted with noncompliant billing codes. Summit Community Care uses code-editing software to determine which services are considered part of, incidental to, or inclusive of the primary procedure. Paper and electronic claims must be filed within 365 calendar days.
2021 Provider Manual