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  • OFFICE OF INDIVIDUAL AND FAMILY AFFAIRS - AHCCCS
    A Single Case Agreement (SCA) is an agreement between the health plan (insurance company) and an out-of-network provider (doctor or specialist) to provide services, typically to one member These agreements can be used to deliver medically necessary covered services to a Medicaid member if those services are not available within
  • Manuals and Forms - AZ Complete Health
    Arizona Complete Health-Complete Care Plan (Medicaid) Please note that all Provider Manual forms are available upon request by calling our Provider Customer Service line at 1-866-796-0542 Authorization for Release - Psychtherapy Notes - English (PDF)
  • Provider forms | UHCprovider. com
    Health care professionals can access forms for UnitedHealthcare plans, including commercial, Medicaid, Medicare and Exchange plans in one convenient location
  • What Is A Single Case Agreement? A Brief Guide - Project HEAL
    Single Case Agreements With Medicaid and Medicare SCAs can be obtained and are often needed with Medicaid plans, when there are often no in-network options and no out-of-network benefits are available This is especially common in Medicaid plans when residential level-of-care is being requested SCAs are not possible with traditional Medicare
  • What is A Single Case Agreement (SCA) For Out Of Network Providers?
    Sometimes referred to as SCA, Single Case Agreement is essentially a contract between an insurance company and an out-of-network provider to ensure that a client doesn’t have to change providers It’s especially important for clients who need extended long-term treatment or therapy
  • SC. UM. 17. 01 - Single Case Agreements - Absolute Total Care
    To provide instruction on obtaining, documenting and implementing single case agreements (SCA) with non-participating health care providers authorized to provide covered services to health plan members or services not addressed in the participating provider contract
  • Understanding Medicaid Single Case Agreements: An In-Depth Look
    In order to obtain a Medicaid Single Case Agreement, the insurance provider (or provider representative) must submit a written request to the local County Department of Human Services Office The Single Case Agreement request form can be downloaded from the Medicaid Provider Enrollment website
  • GUIDES AND MANUALS FOR HEALTH PLANS AND PROVIDERS - AHCCCS
    AHCCCS Contractor Expenditure Report (CER) Form and Instructions; AHCCCS Contractor Operational Manual (ACOM) AHCCCS Covered Behavioral Health Service Guide (CBHSG) AHCCCS DUGless Portal Guide (Updated Oct 2020) AHCCCS Data Validation Technical Document July 2023; AHCCCS Dental Uniform Warranty; AHCCCS Enrollment Rate Codes and Values
  • Medical Management Utilization Management Requirements - AZ Complete Health
    If the clinical team has made all attempts to find a contracted provider for a medically necessary service and is unable to secure the service within the required timeframes, the clinical team may submit a Single Case Agreement to the Health Plan for the service
  • Provider forms, programs and references | UnitedHealthcare Community . . .
    Forms and other resources for Arizona AHCCCS Medicaid, Children's Rehabilitative Services (CRS), Developmentally Disabled Program, and Long Term Care providers





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