SummaCare’s "Provider News" is meant for physicians and office staff and features health insurance news, health and wellness information, clinical and quality management information, helpful tips for providing care to SummaCare members and important reminders from our Provider Support Services team. If you’d like to receive the Provider e-newsletter, please register for Plan Central using the Provider Registration link.
View archived newsletters and memos below:
September
New Pre-Admission Testing Policy
Outpatient Prior Authorization Requirements
Annual Provider Update Webinar
August
Modifier 25 Payment Policy
GuidingCare Go-Live Delay
Pharmacy Site of Care Policy and Drug List
July
Provider Q3 Newsletter
GuidingCare Registration and Training Videos
June
GuidingCare New Prior Authorization Portal
May
Provider Changes/Reminder Notification
New Prior Authorization Requirements
April
Provider Q2 Newsletter
Prior Authorization for Out of Network Labs
March
Ambulatory Surgical Center Certification Requirement
February
Medical Pharmacy Partnership with Prime Therapeutics
January
Provider Q1 Newsletter
December
Claim Edit Details
Transition of Care Code Pilot
Provider Formulary Change
November
SummaCare Medicare Out of Network Referrals
NDC Guidance
October
CPT Code 96127
SummaCare vs EviCore Prior Authorization
Medicare Prescription Payment Plan
Behavioral Health Quality of Care
September
Critical Access Hospital Billing
Non-Emergency Ambulance Services
August
Annual Provider Update Webinar
July
May
Non-Emergency Transport
Change HealthCare Reconnection
Hospital-Based Clinic Services
April
Hospital-Based Clinic Services
Ambulatory Surgery Center Memo
New Specialty Drug Editing Software
Provider Q2 Newsletter
March
An Update on Prior Authorization
Change Healthcare Updates
Medicare Unlikely Edits Memo
KX Modifier Letter
February
Change HealthCare Disruption
January
Provider Q1 Newsletter
Inpatient Only Procedures Letter
December
Formulary Change Letter
August
Provider Q3 Newsletter
January
Provider Q1 Newsletter
Provider Memo: Network Letter
Provider Memo: Colorectal Screening Measure Update
Provider Memo: Kidney Health Evaluation for Diabetic Patients
December
Provider Memo: Fee Schedule Change
October
Provider Memo: Q4 Updates
August
Provider Memo: Q3 Updates
April
Provider Memo: SUPD
Provider Memo: SUPD Expanded List
Provider News 04.19.22: Q2 Updates
Provider Memo: BrainHQ
February
Provider Memo: Change to Back Program Prior Authorization
Provider News 02.14.22: Q1 Updates
December
Provider Memo: Summa Health System’s Employee Assistance Program
Provider Memo: Check Your Networks
October
Provider News 10.13.2021: Q4 Updates
August
Provider Memo: Behavioral Health and Utilization Management
Provider Memo: Concurrent Review for Acute Rehab and LTACs
July
Provider News 07.06.2021: Q3 Updates
May
Provider Memo: Evicore Auth Requests
Provider Memo: Radiology Reads
April
Provider News 04.22.2021: Q2 Updates
March
Provider Memo: Incomplete Prior Auth Form
February
Provider News 02.11.2021: Register Now: SummaCare's Vendor Spotlight
January
Provider Memo: Procedure and Surgery Prior Authorizations
Provider News 01.26.2021: Q1 Updates
Read Vital Coverage, SummaCare’s bi-weekly blog dedicated to bringing the latest health insurance news, benefits and updates as well as health and wellness tips.
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If you have not met with your assigned Provider Engagement Specialist or would like to schedule an in-office training or meeting to address any questions regarding the authorization process, claims issues, appeals, SummaCare products/benefits or Plan Central training, please contact the assigned Provider Engagement Specialist for your office.
View patient eligibility, benefits, claims status, and self-funded prior authorization lists, as well as review clinical edits and clarifications.