Claims
In addition to information about how to submit claims and check payments, CareSource® offers you tools to find specific information, such as claim status and member coordination of benefits (COB) status.
CareSource accepts claims in a variety of formats, including online and paper claims.
Recommended Option: Submit Claims Online
Providers have the option to submit claims through our secure, online Provider Portal. You can submit claims, track claim payments and more. CareSource offers this service at no cost.
Submit Claims Online Using the CareSource Provider Portal
We encourage you to submit claims online to take advantage of the following benefits:
- Faster claim processing
- Reduced administrative costs
- Reduced probability of errors or missing information
- Faster feedback on claim status
- Minimal staff training or cost
| Helpful Tools & Resources | |
|---|---|
Refer to the CareSource Provider Manual for detailed information on how to submit claims. | CareSource also partners with Availity to offer electronic claim submission and real-time transactions at no charge. |
Availity Portal Registration Guide Utilize this guide to get started with Availity registration. | |
Get Paid Electronically
CareSource has partnered with ECHO Health, Inc. to deliver provider payments. ECHO offers three payment options:
- Electronic fund transfer (EFT) – preferred
- Virtual Card Payment (QuicRemit) – Standard bank and card issuer fees apply*
- Paper Checks
*Payment processing fees are what you pay your bank and credit card processor for use of payment via credit card.
Enrollment Instructions
Enroll with ECHO for payment and choose EFT as your payment preference for CareSource.
Questions? Call ECHO Customer Support at 1-833-629-9728.
Alternative Method: Paper Claims
For the most efficient processing of your claims, CareSource recommends you submit all claims electronically via the Provider Portal. Paper claim forms are encouraged only for services that require clinical documentation or other forms to process.
Please send all paper claim forms to CareSource at the following address:
CareSource
Attn: Claims Department
P.O. Box 803
Dayton, OH 45401
Refer to the Provider Manual for instructions to submit paper claims.
Non-Participating Providers
Nonparticipating providers may submit claims to CareSource using the Non-Participating Provider Profile Form. CareSource is unable to process claims without this information. Please be sure to attach your W-9 form when you submit this online form.
Claim Overpayment Recovery Requests and Resources
NavigateOverpayment Recovery Form – Submit this form to offset overpaid claims against a future payment.
High-Dollar Claims
Submit this Navigate cover sheet and itemized statement for high dollar claims.
| More Information | |
| For additional information regarding the provider disputes and appeals, please visit the Disputes and Appeals webpage. Provider Services Call Center specialists are available to help review your claims and advise of next steps at 1-855-202-1058. | |