Summary
CareSource has updated its Provider Claim Submission feature. The new portal contains all the functionality that is in place today with a new look and feel. You will still have access to the previous functionality, including the features listed below:
Features
Claim Entry Health Insurance Claim Form (HCFA), Uniform Billing (UB) Form, Dental
Claim Entry HCFA, UB, Dental – Partial form save & begin at previous saved location
Claim Entry HCFA, UB, Dental – Recent History
Claim Entry HCFA, UB, Dental – Clone Claim (Full, Partial)
Claim Entry HCFA, UB, Dental – Resubmission
Claim Attachment
Claim Upload – No Direct Data Entry required
Copy a previously submitted claim
Pre-Load Provider Information (NPI, TIN, Billing address and name)
End User Dashboard
Search Capability
Document Status Tracking
Impact
Providers who have saved a draft claim will no longer be able to access that draft once the changes go into effect. Claims previously submitted through our existing Claim Submission feature within the last 45 days cannot be viewed through the new Claims Submission page, but can be viewed on the Provider Portal by searching for a claim by Claim Number.
Importance
There are new user guides and training videos available to help you get familiar with the new Claim Submission feature. These are available on the Provider Portal under Users > Provider Training.
Questions?
:
• HAP CareSource: 1-833-230-2102, available Monday through Friday from 7 a.m. to 8 p.m.
Eastern Time (ET)
• HAP CareSource MI Health Link: 1-833-230-2159, available Monday through Friday from 8
a.m. to 6 p.m.( ET)
Member Billing Policy, State and federal regulations prohibit providers from billing CareSource D-SNP and Ohio MyCare members for services provided to them except under limited circumstances.
Process for Billing D-SNP Claims:
To help reduce the instances of balance billing, remember the following steps:
Network providers may not balance bill CareSource D-SNP members for covered services. If you have questions regarding billing policies, please reach out to your Health Partner Representative or call Provider Services at 1-833-230-2176 for D-SNP or 1-800-488-0134 for Ohio MyCare.
Member Billing Policy, State and federal regulations prohibit providers from billing CareSource D-SNP members for services provided to them except under limited circumstances.
Process for Billing D-SNP Claims:
To help reduce the instances of balance billing, remember the following steps:
Network providers may not balance bill CareSource D-SNP members for covered services. If you have questions regarding billing policies, please reach out to your Health Partner Representative or call Provider Services at 1-833-230-2176.
You may have unused babies First® or Kids First rewards that are expiring on June 15th. Please redeem the rewards on your CareSource OTC card today. Call us with any questions at 1-844-607-2829 (TTY: 711). We are open Monday through Friday, 8 a.m. to 8 p.m., Eastern Time.
NEW! Active&Fit Direct: Now even if you didn’t choose a Dental, Vision & Fitness CareSource plan, you can join Active&Fit Direct any time with no contract and you can switch fitness centers or join more than one! Join one by work and one by your home! Change any time you like. You can use workout videos at home, or even get one-on-one wellness coaching by phone!
To sign up for Active&Fit Direct go to: https://www.activeandfitdirect.com/fitness/AF640027CA. Get a $0 enrollment fee through June 30 with code StayStrong. You will need to pay 2 months up front to get started. After that, it is just $28 monthly.
NOTE: DENTAL, VISION & FITNESS PLAN MEMBERS! SIGN UP/ACCESS YOUR ACCOUNT THROUGH THE ACTIVE&FIT WEBSITE!
Change Healthcare Cybersecurity Incident
Content: CareSource is aware of the recent cybersecurity incident with Change Healthcare. Our trading partner, Availity, has taken appropriate measures to protect patient data and has opted to temporarily restrict communication with the Change Healthcare clearinghouse from inbound and outbound transactions.
CareSource is aware of the recent cybersecurity incident with Change Healthcare. Our trading partner, Availity, has taken appropriate measures to protect patient data and has opted to temporarily restrict communication with the Change Healthcare clearinghouse from inbound and outbound transactions.
Medicaid Providers – Learn more.
Marketplace and D-SNP Providers – Learn more.
Change Healthcare Cybersecurity Incident
CareSource is aware of the recent cybersecurity incident with Change Healthcare. Our trading partner, Availity, has taken appropriate measures to protect patient data and has opted to temporarily restrict communication with the Change Healthcare clearinghouse from inbound and outbound transactions.
Change Healthcare Cybersecurity Incident
CareSource is aware of the recent cybersecurity incident with Change Healthcare. Our trading partner, Availity, has taken appropriate measures to protect patient data and has opted to temporarily restrict communication with the Change Healthcare clearinghouse from inbound and outbound transactions.
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