Great News Ohio Providers

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Thank you for your participation with CareSource! We are committed to making it easier for you and your staff to work with us by implementing key operational improvements. Improvements include:

  • 2012 Provider Manual – CareSource recently launched the 2012 Provider Manual. Visit the 2012 manual for the most recent policies and procedures
  • Flu Vaccines – CareSource will pay for members to receive flu vaccines at pharmacies. CareSource members who are 19 years of age and older may go to any CareSource network pharmacy that provides the vaccinations. A list of network pharmacies can be found on our Find a Pharmacy online tool. CareSource members also may continue to obtain their flu vaccine at their provider’s office. Members who are younger than 19 years of age should obtain their flu vaccine in coordination with the Vaccines for Children (VFC) program.
  • Prescription Drug Coverage Change – Effective October 1, 2011, prescription drug coverage for members of Ohio Medicaid transferred to Ohio’s Medicaid Managed Care Plans (MCPs). Learn more about this important change and/or access the Preferred Drug List.
  • Electronic Funds Transfer - Electronic Funds Transfer (EFT) is now live for Ohio Providers! EFT is simple, convenient, reliable and secure. Enroll today!
  • Timely Filing Extended - Timely Filing for Ohio Providers has been extended from 180 to 365 days!
  • Proactive Coordination of Benefits Policy - CareSource has improved its COB policy to benefit our providers, learn more about how your practice can benefit.
  • Updates to our Secure Provider Portal - Recent improvements included member dental and vision history, the ability to check appeal status and search for a claim by check number.
  • Clinical Tools Added - The CareSource Member Profile and new Clinical Practice Registry can help you improve patient outcomes. These tools are on our secure provider portal.
  • Medical Policies - We've added Medical Policies on our website that provide guidance on determining medical necessity and appropriateness of care for a wide range of approved benefits.
  • Focus on Participating Hospitals - CareSource recently added a hospital phone queue as part of service operations to improve customer service to our participating hospitals. Simply call 1-800-488-0134.

Plan Service Areas - Ohio Medicaid

Covered Families and Children

Central Region

Crawford, Delaware, Fairfield, Fayette, Franklin, Hocking, Knox, Licking, Logan, Madison, Marion, Morrow, Perry, Pickaway, Pike, Ross, Scioto and Union counties

East Central Region

Ashland, Carroll, Homes, Portage, Richland, Stark, Summit, Tuscarawas and Wayne counties

Northeast Region

Asthabula, Cuyahoga, Erie, Geauga, Huron, Lake, Lorain and Medina counties

Northeast Central Region

Columbiana, Mahoning and Trumbull counties

Southeast Region

Athens, Belmont, Coshocton, Gallia, Guernsey, Harrison, Jackson, Jefferson, Lawrence, Meigs, Monroe, Morgan, Muskingum, Noble, Vinton and Washington counties

Southwest Region

Adams, Brown, Butler, Clermont, Clinton, Hamilton, Highland and Warren counties

West Central Region

Champaign, Clark, Darke, Greene, Miami, Montgomery, Preble and Shelby counties

Aged, Blind or Disabled

Central Region

Crawford, Delaware, Fairfield, Fayette, Franklin, Hocking, Knox, Licking, Logan, Madison, Marion, Morrow, Perry, Pickaway, Pike, Ross, Scioto and Union counties

East Central Region

Ashland, Carroll, Holmes, Portage, Richland, Stark, Summit, Tuscarawas and Wayne counties

Northeast Region

Ashtabula, Cuyahoga, Erie, Geauga, Huron, Lake, Lorain, and Medina counties

Northeast Central Region

Columbiana, Mahoning and Trumbull counties

Northwest Region

Allen, Auglaize, Defiance, Fulton, Hardin, Henry, Lucas, Mercer, Ottawa, Paulding, Putnam, Sandusky, Seneca, Van Wert, Williams, Wyandot and Wood counties

Southeast Region

Athens, Belmont, Coshocton, Gallia, Guernsey, Harrison, Jackson, Jefferson, Lawrence, Meigs, Monroe, Morgan, Muskingum, Noble, Vinton and Washington counties

West Central Region

Champaign, Clark, Darke, Greene, Miami, Montgomery, Preble and Shelby counties

Medicare Advantage Special Needs Plan for Dual Eligibles

Medicare Advantage Ohio

Butler, Cuyahoga, Delaware, Franklin, Greene, Hamilton, Lorain, Lucas, Madison, Mahoning, Medina, Montgomery, Stark, Summit, Trumbull, Warren, Wood

Montgomery County Care

Montgomery County Care is a pilot health care services program that provides a cost-effective primary care medical home for eligible adults who live in Montgomery County, Ohio. The program was developed out of recommendations from the Montgomery County Health Care Safety Net Task Force and is funded through an award from the Montgomery County Human Services Levy.