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Provider News

Community Care, Inc. invites you to complete a Satisfaction Survey regarding your interaction with our Care Teams, Claims Department or Provider Management Department.  Your input is valuable to us and greatly appreciated. It provides us with helpful information to improve our provider interactions. Thank you for your time and consideration. 

NEW SURVEY LINK! - Please take a few minutes to complete our survey.

Requests for Proposal

Community Care, Inc. is seeking interested providers to work with Community Care to create a supportive environmental and meaningful life experiences for individuals. Please click below for the following opportunities. If there are none, please check back frequently for updates.

Community Care periodically issues Requests for Proposals (RFPs). Please check back often for any current RFPs. 
Member Profile# 01 01.2024
Member Profile# 02 01.2024

Member Profile # 03.01.2024

  Provider Advisory Committee

Providers are encouraged to share information, input and feedback with us to create a better partnership and continue to raise the standard in care. You can reach our Provider Management Department by calling 866-937-2783 or emailing [email protected]. Suggested agenda topics for meetings can be addressed to Provider Advisory Committee members and minutes from those meetings are published on Community Care's website.  To express interest in joining the Provider Advisory Committee you may email  [email protected].

Committee Members
  • Dan Drury, Options for Community Growth
  • April Juett, AJ's Living
  • Bill Gudwer, Limitless Possibilities
  • Norris Jones, Southern Hope Homes
  • Victor Reale, Atrium
  • Krista McCook, Mosaic
  • Zayed Kadadha, First Care Transportation
  • Bashar Qedan, Open Arms 20
Committee Meeting Minutes Provider News - September, 2013 Provider News - May, 2013 Provider News - August, 2012

NOTICE:  Change to Authorization Policy – 11/1/2018:

Beginning November 1st, 2018 Community Care, Inc. will no longer require prior authorization for services where Medicare or other non-Medicaid insurance providers  are the primary insurer and Family Care is responsible only for deductibles , coinsurance or cost shares. This includes most DME, therapy, mental health services, and Medicare SNF Part A stays where Family Care acts as the beneficiary’s Medicaid replacement plan. 

Community Care, Inc. may still choose to send an authorization or communicate in other ways with providers of these services; however, this does not imply the service will be approved without submission to Medicare or other liable parties first unless that is explicitly stated on an authorization. Claims approved by another insurer will not require an authorization for payment of deductibles and co-insurances or cost shares, but will still be subject to other claim processing standards, and claims may be denied if the other insurance does not approve payment. Per 1902(a)(25) of the Social Security Act, Medicaid is the payer of last resort meaning that Medicaid will only pay for services after all liable insurers have met legal obligations to pay.

Providers must work directly with the member’s physician to obtain supporting documentation and prior authorization required by the member’s primary insurance.  If it is not possible to obtain coverage from the primary payer, providers must provide an ABN (Advance Beneficiary Notification of Non-Coverage) or other suitable documentation that the beneficiary does not meet coverage criteria to IDTS (Interdisciplinary Team Staff) prior to the delivery of any equipment or service. Community Care will not pay primary for benefits covered by a member’s primary insurance when the denial reason is lack of sufficient paperwork or without prior authorization by IDTS. When a primary insurance denies coverage, Community Care, Inc. will not approve payment unless we have provided an authorization in advance to the provider indicating that we will pay as the primary insurer.

This new coverage policy applies only to Family Care members for benefits covered by Medicare or other primary insurance at the time of service beginning November 1st 2018. There are no changes to the coverage policy for Medicaid only Family Care members or benefits not covered by Medicare or another primary insurer. These services will continue to require prior authorization as a condition of payment.

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