APA Bridge Payment

APA Continuation and Reconciliation

Additional Information on APA Models (7/14/2020)

Timelines

Other 


4/7/2020 Update

In an effort to achieve greater consistency for providers across Pennsylvania, Community Care in collaboration with its county partners is updating our APA Ambulatory Bridge Payment Model to align with a common feature of APAs across the Commonwealth. Community Care will issue bridge payments equal to 100% of provider historic utilization patterns. In the next two weeks, providers will receive a partial payment for March 15, 2020 - April 14, 2020 utilization to bring total payments to 100%. Providers are expected to continue to deliver services and submit claims. All payments will be reconciled to a minimum of 100% of historical trend.


4/1/2020 Update

First, Community Care will be sharing further details about the levels of care included in the bridge payment calculation, with details regarding amounts included from each of our HealthChoices primary contractor/county partner(s) as applicable. We will share details about how to access these files with participating providers, as soon as the files are available. Please also know Community Care is actively working on responses to other common questions we have been receiving from providers regarding the structure and other details about the APA, which will be issued as additions to our FAQs soon. And finally, a reminder to all participating providers to please complete and submit your survey response on ambulatory service operations during the crisis to Community Care as soon as possible. We will not release future bridge payments to providers who have not completed and submitted their survey response to Community Care. We ask providers to submit responses by no later than COB on Wednesday, April 15, in order to prevent delays of future bridge payments which are scheduled to be released with claims payments on Friday, April 24 and received/posted for providers early the following week (April 27/28). Instructions on completion of the survey were included in the email sent with participating provider contract amendments last week.