Notice Date: December 2, 2024 To: Ohio D-SNP, Marketplace, Medicaid, MyCare Behavioral Health Providers From: CareSource Subject: CareSource Connections Effective Date: January 1, 2025 Summary The Behavioral Health (BH) Provider Relations team is excited to continue CareSource Connections throughout 2025 , our monthly operational engagement platform. CareSource Connections is dedicated to Behavioral Health Providers , including but not limited to: Community Behavioral Health Centers, BH private practice providers, and Applied Behavioral Analysis (ABA) providers across the state of Ohio. Education and training t opics are specific to Ohio BH operations, such as claims processing trends & education, how to submit a Prior Authorization (PA), portal education, dispute process , contracting & credentialing process, fee schedule inquiries, CareSource.com navigation, operational issues/inquiries, and much more! Impact Ohio BH Providers are welcome to directly engage and connect with the CareSource BH Provider Relations team and fellow BH providers . 2025 schedule* for CareSource Connections below: Date Day of the Week Start End In-Person /Virtual January 16, 2025 Thursday 9:00 a.m. (ET) 10:00 a.m. (ET) Virtual Only **February 20, 2025 Thursday 11:30 a.m. (ET) 12:30 p.m. (ET) Columbus /Virtual March 20, 2025 Thursday 3:00 p.m. (ET) 4:00 p.m. (ET) Virtual OnlyApril 17, 2025 Thursday 9:00 a.m. (ET) 10:00 a.m. (ET) Virtual Only**May 15, 2025 Thursday 11:30 a.m. (ET) 12:30 p.m. (ET) Cleveland /VirtualJune 19, 2025 Thursday 3:00 p.m. (ET) 4:00 p.m. (ET) Virtual OnlyJuly 17, 2025 Thursday 9:00 a.m. (ET) 10:00 a.m. (ET) Virtual Only**August 21, 2025 Thursday 11:30 a.m. (ET) 12:30 p.m. (ET) Dayton /VirtualSeptember 18, 2025 Thursday 3:00 p.m. (ET) 4:00 p.m. (ET) Virtual Only October 16, 2025 Thursday 9:00 a.m. (ET) 10:00 a.m. (ET) Virtual Only November 2025 No Meeting due to holiday December 2, 2025 Tuesday 11:30 a.m. (ET) 12:30 p.m. (ET) Virtual Only * Dates subject to change **Represents in-person option, details to be shared during monthly calls Registration To register for our webinars , email updates & communications from the BH Provider Relations team, please complete this form: CareSource Connections Communications . You may also send an email titled CareSource Connections to Care Source_OH_BH@ Care Source.com requesting to join. Once received, a BH Provider Relations team member will provide you with the link for the Microsoft Teams webinar. Please include the following in your email: Agency Name Email(s) you want added to the meeting invites Agency type: BH Private Practice, Community Mental Health Center (type 84/95), ABA Provider Questions? If you have specific training ideas or BH operational needs, please email in advance of a CareSource Connections meeting for the CareSource BH Provider Relations team to research and provide education and feedback on subsequent webinars. Send your email titled CareSource Connections to CareSource_OH_BH@CareSource.com . OH-Multi-P-3452703
Member Frequently Asked Questions (FAQs)Behavioral Health Services Changes in Macomb County | HAP CareSource MI Health Link (Medicare-Medicaid Plan)1. What is changi ng if you are receiving behavioral health services from Macomb County CommunityMental Health? Your behavioral health services and care you are receiving from Macomb County Community Mental Health (MCCMH) will remain as is . The only difference is that HAP CareSource will manage the services rather than M CCMH. 2. When is the change taking effect?January 1, 2025.3. Will my current behavioral health provider in Macomb County change?HAP CareSource is working to contract with your Behavioral Health providers. 4. Will any of the changes taking place affect your current care and/or services?No. Your benefits are not changing. The only thing that is changing is who manages those benefits.5. Who should I contact for behavioral health care coordination? You can continue to work with your care coordinator at MCCMH through December 31 , 202 4. Your HAP CareSource care coordinator is always available to you. You can call them directly or call HAP CareSource Member Services at 1-833-230-2057 (TTY: 1-833-711-4711 or 711) . 6. Are there any other changes I should be aware of?Yes. You will receive a new HAP CareSource MI Health Link member ID card in the mail in December . Please throw away your current member ID card and use the new one . 7. Who should I contact with general behavioral health services questions?If you have a question before January 1, 202 5, call MCCMH at 1-855-996-2264 (TTY : 711). If you have a question on or after January 1, 2025, call HAP CareSource MI Health Link Member Services at 1-833-230 – 2057 (TTY: 1-833-711-4711 or 711) . 8. Who should I call if I am having a behavioral health related crisis?Call MiCal 988 or 911 for behavioral health related crisis. You can also call HAP CareSource MI Health Link Member Services at 1-833-230-2057 (TTY: 1-833-711-4711 or 711) . 9. What is the process if I need to file a grievance or appeal regarding a behavioral health related service? Grievances and appeals for services that were delivered prior to January 1, 2025, will be handled byMCCMH. Grievances and appeals for services that were delivered on or after January 1, 2025, will be handled by HAP CareSource MI Health Link . 10. Is there a direct line if I need to file a behavioral health related complaint?For complaints for behavioral health services through December 31, 2024, please contact MCCMH. For complaints for services on or after January 1, 2025, please call HAP CareSource MI Health Link. If you have any questions, please call Member Services at 1-833-230-2057 (TTY: 1-833-711-4711 or 711) , 8 a.m. to 8 p.m., Monday through Friday. HAP CareSource MI Health Link (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. H9712_MI-MMP-M- 3402041 | C MS/MDHHS Approved: 11/20/2024HAPCareSource.com
WI-EXC-P-3227821 ITEMIZED BILL COVER SHEET Instructions for completion : Section 1 must be complete at the time of submission.The sheet should be typed, rather than handwritten.Submit the cover sheet and itemized statement using any of the following methods:oEmail: ClaimsItemizedBills@CareSource.com o Fax: 1-937-396-3173o Phone (toll free): 1-844-794-1579File size is limited to 12MB. Large files should be sent in multiple emails.Please fill out Section 2 below accordingly.Submit a cover sheet with each email. Section 1-REQUIRED Section 2 OPTIONAL (as appropriate) Line of Business*: ____________________________________________________*Use the following as applicable: Wisconsin MarketplacePatient Name: Last: ____________________________________________________ First: ____________________________________________________ CGHC ID: _________________________________________________Dates of service: From: ________________Thru: _________________ Will the itemized bill need to be split up into multiple emails due to size? YesIf yes, how many? ________________No
Notice Date: December 2, 2024 To: Ohio Medicaid Providers From: CareSource Subject: Brand Name Buprenorphine-Naloxone Take-Home Doses (Suboxone, Zubsolv) Effective Date: January 1, 2025 Summary CareSource requires prior authorization on brand name (Suboxone, Zubsolv) buprenorphine-naloxone take-home doses billed using code S5001. Our prior authorization lists can be found on CareSource.com . For prior authorization requirements by code, please utilize our Prior Authorization Look Up Tool and Provider Policies . Prior authorization is not a guarantee of payment of services and can be dependent, but not limited to, the following criteria: Member eligibility Members under 21 years old Medical necessity Covered benefits Modifiers Diagnoses and revenue codes Limits and number of old visit variances Provider contracts Provider types Correct coding and billing practices For faster authorization submission and to review the status of any authorization, please utilize the CareSource provider portal . Impact For members currently utilizing brand name buprenorphine-naloxone take-home doses, a prior authorization will need to be obtained to continue use or members can switch to a generic formulation. Questions? Please contact Provider Services at 1-800-488-0134, available Monday through Friday from 8 a.m. to 6 p.m. Eastern Time (ET). OH-MED-P- 3216642
Notice Date: December 1, 2024 To: Georgia D-SNP Providers From: CareSource Subject: December 2024 Policy Updates Effective Date: February 1, 2024 Summary At CareSource, we listen to our providers, and we streamline our business practices to make it easier for you to work with us. We have worked to create a predictable cycle for releasing administrative, medical and reimbursement policies, so you know what to expect. Check back each month for a consolidated network notification of policy updates from CareSource. How to Use This Network Notification Reference the list of policy updates. Note the effective date and impacted plans for each policy. Click the hyperlinked policy title to open the webpage with the full policy. Find Our Policies Online To access all CareSource policies, visit CareSource.com > Providers > Tools & Resources > Provider Policies. Select your plan and state, then the type of policy. Each policy page has an archive when you find previous versions of policies. PoliciesPolicy Name and NumberPolicy Type Plan Effective Date PriorAuthorization Impacted? Continuity of CareAD-1385ADMINISTRATIVE D-SNP FEBRUARY 1, 2025 REVISION Esophageal Brush BiopsyAD-1400ADMINISTRATIVE D-SNP FEBRUARY 1, 2025 REVISION Molecular DiagnosticTesting AD-1362ADMINISTRATIVE D-SNP FEBRUARY 1, 2025 REVISION Pharmacogenomics-GeneTesting for Behavioral HealthIndications MM-1714MEDICAL D-SNP FEBRUARY 1, 2025 REVISIONY0119_GA-DSNP-P -3456111_C ReadmissionAD-1234ADMINISTRATIVE D-SNP FEBRUARY 1, 2025 REVISION Retrospective Authorization Review AD-1339 ADMINISTRATIVE D-SNP FEBRUARY 1, 2025 REVISION Safety Beds MM-1454 MEDICAL D-SNP FEBRUARY 1, 2025 REVISION
Get free help in your language with in terpreters and other written mate rials. Get free aids and support if you have a disability. Ca ll 1-833-230-2099 (TT Y: 711). Obtenga ayuda gratuita en su idioma a travs de intrpretes y otros materiales en formato escrito . O btenga ayudas y apoyo gratuitos si tiene una discapacidad. Llame al: 1-833-230-2099 (TTY: 711). Jw enn d g ratis nan lang ou ak entprt ansanm ak lt materyl ekri. Jwenn d ak sip gratis si w gen yon andikap. Rele 1-833-230-2099 (TTY: 711). . . TTY ( 1-833-230-2099 " ": . ) 711 1-833-230-2099 711 Erhal ten Sie kostenlose Hilfe in Ihrer Sprache durch Dolmetscher und andere schriftliche Unterlag en. Beziehen Sie kostenlose Hilfsmittel und Untersttzung, wenn Sie eine Behinderung ha ben. Rufen Sie folgende Telefonnummer an : 1-833-230-2099 (TTY: 711). Obtenez un e aide gratuite dans votre langue grce des interprtes et dautres documents crits . S i vous souffrez dun handicap, vous bnficiez daides et dassistance gratuites. Appelez le 1-833-230-20 99 (ATS : 711 ). Nh n t r gip min ph bng ng n ng ca qu v vi th ng d ch vi n v c c ti li u b ng vn bn kh c. Nhn tr gip v h tr mi n ph nu qu v b khu yt tt. Gi 1-833-230-2099 (TT Y: 711). Grick Helfe mitaus Koscht in dei Schprooch mit Iwwersetzer un annere schriftliche Dinge. Grick Aids un Helfe mitaus Koscht wann du en Behinderung hoscht. Ruf 1-833-230-2099 (TT Y: 711). , 1-833-230-2099 (TTY: 711). . , . 1-833-230-2099 (TTY: 711) . 1-833-230-2099 (TTY 71 1) Gba irnlw f ni d r plu wn ogbif ti wn ohun lo mirn t i a k sil. Gba wn irnlw ti tilyin f bi o b a ni ilera kan. Pe 1-833-230-2099 (TTY: 711). Makakuha ng libreng tulong sa wika mo gamit ang mga interpreter at mga ibang nakasulat na materyales. Makakuha ng mga libreng pantulong at suporta kung may kapansanan ka. Tumawag sa 1-833-230-2099 (TTY: 711). . . .(TTY: 711) 1-833-230-2099 . , . :1-833-230-2099 (TTY: 711). 1-833-230-2099 (TTY: 711) – 1-833-230 – 2099 (TTY: 711) Bk jiba ilo an ejjelok wnn ikkijjien kajin eo am ibbn rukok ro im wween ko jet ilo jeje. Bk jerbalin jiba ko ilo an ejjelok wner im jiba ko e ewr am nainmejin utamwe. Kalle 1-833 – 230-2099 (TTY: 711). MI-EXC-M-3283767 Non-Discrimination Notice We follow all state and federal civil rights laws. We do not discriminate, exclude, or treat people differently based on race, color, national origin, disability, age, religion, sex ( which includes pregnancy, gender, gender identity, sexual preference, and sexual orientation ), or based on marital, health, or public assistance status. We want all people to have a fair and just chance to be as healthy as they can be. We offer free aids, services, and reasonable modifications if you have a disability. We can get a sign language interpreter. This helps you talk with us or to your providers. Get your printed materials in large print, audio, or braille at no cost. We can a lso help if you speak a language other than English. We can get an interpreter who speaks your language. Or get printed materials in your language. You can get this all at no cost to you. Call 1-833-230-2099 (TTY: 711) if you need any of this help. We are open Monday through Friday, 7 a.m. to 7 p.m. ET. We are here for you. You may file a grievance if we did not provide these services to you or if you think we discriminated in any other way. Mail : HAP CareSource Attn: Civil Rights Coordinator P.O. Box 1947 Dayton, OH 45401 Phone: 1-844-539-1732 (TTY: 711) Fax: 1-844-417-6254 Email : CivilRightsCoordinator@CareSource.com You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Mail 8.S. De Sartment o I Health an G Human Ser Yices 200 ,n Ge Sen Gence A Ye. S. :. 5oom 09F HHH %uil Gin J :ashin Jton D.C. 20201 Mail the com Slaint Iorm Ioun G at Z Z Z.hhs. Jo Y sites Ge Iault Iiles ocr-cr-com Slaint- Iorm- Sac Na Je. S G I . Phone 1-800-3 8-1019 7 7