Provider Services

Why participate with CareSource?

A focus on preventive health care and personal service is core to CareSource's operating philosophy. For participating health care providers, we offer:

  • Enhanced reimbursement - CareSource offers a competitive reimbursement for its valued providers.
  • Claims call center - A call center dedicated to provider claims inquiries is staffed with claims experts for prompt issue resolution.
  • Web-based transactions and electronic claims submission - CareSource has the technology to support a variety of electronic transactions with participating providers.
  • 24-hour member eligibility verification - Member eligibility can be verified any time of the day or night online or through our automated phone system or on our secure provider portal.
  • Paperless referral system - Hassle-free medical management and less paperwork mean more time to focus on patient care.
  • Commitment to service - We answer providers' questions quickly and accurately and offer orientations and in-service programs for providers and their office staff.
  • Member support services - CareSource can assist with patient compliance with services such as a 24-hour nurse advice line, case management and health education.

Learn more about how easy Credentialing is with CareSource.

Our Services

CareSource's foundation is our strong partnership with our contracted health care providers. Through you, we fulfill our mission of making a difference in the lives of underserved people by improving their health care.

Because the satisfaction of our health care providers is so important to us, we offer a wide array of services and benefits including quick claims payment, enhanced reimbursement, a secure provider portal available 24/7 and more.

Provider Service Center

How to reach us

Call Provider Services toll-free at 1-800-390-7102. Press the option for providers.

Our friendly and knowledgeable representatives are available to speak with you 8 a.m. to 5:30 p.m., Monday through Friday, except holidays. The menu options will also let you speak with people from our medical management, pharmacy, appeals and Provider Relations departments.

You can call the Provider Services with questions or issues about:

Please have the Michigan Medicaid or CareSource ID number for the member you are calling about ready when you call.

You may also call Provider Services to:

  • Ask questions about your contract, claims, claim submission, checks, or Explanations of Payment (EOP)
  • Report possible fraud
  • Get help with electronic billing and other Electronic Data Interchange (EDI) issues

Please have your CareSource provider ID number ready when you call.

Enhanced Reimbursement

CareSource offers a competitive reimbursement for its valued providers.

We also offer a performance bonus to Primary Care Providers for providing certain well-child checkups, immunizations and preventive exams for CareSource patients.

This example below shows enhanced reimbursement on a 42-Year-Old Woman:

 New patient  Payment
 CPT 99386  $117.10
 10% Premium  $11.71
 Pay for performance  $30.00
 Pay for performance PAP  $50.00
 Pay for performance Mammogram  $50.00
 Total:  $258.81

Provider Portal

CareSource's secure online Provider Portal makes it easier for you to work with us. The portal is easy to access, whenever it is convenient for you. This helpful online tool is available for all CareSource health care plans. Assisting you is one of our top priorities in order to deliver better health outcomes for our members. If you are a registered user, or want to become one, please click on Provider Login to perform a variety of web-based transactions such as:

  • Claims Status
  • Member Eligibility
  • Coordination of Benefits (COB)
  • CareSource Clinical Practice Registry
  • Member Profile tool

Provider Relations

Do you have a question about your contract with CareSource? Do you need help with credentialing? Would you like us to conduct an orientation for your office? Has your practice moved or added a new Provider? Do you have an issue with reimbursement?

Whatever the question, our Provider Relations department is here to serve you. Just call Provider Services at 1-800-390-7102. Ask to speak with the Provider Relations representative for your area.

Please see Additional Services for information about the other member support services CareSource offers.