Claims

We want to make it as easy as possible to conduct business with us. 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. 

Recommended Option: Submit Claims Online

Providers have the option to submit claims through our secure, online Provider Portal. You can submit claims and any necessary attachments, track claim payments and more. CareSource offers this service at no cost.

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

CareSource’s traditional providers, community partners and delegates and health homes all may submit claims through the CareSource Provider Portal using online forms. Three types of claims may be submitted:

• Professional medical office claims
• Dental claims
• Institutional claims

Get Paid Electronically

CareSource has partnered with ECHO Health, Inc. to deliver provider payments. ECHO offers three payment options:

1. Electronic fund transfer (EFT) – preferred
2. Virtual Card Payment (QuicRemit) – Standard bank and card issuer fees apply*
3. 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 1-888-834-3511.

Waiver Services Providers

MyCare waiver services providers can also submit claims through the Provider Portal, but they do not use the same process as traditional providers, community partners and delegates and health homes. All claims for waiver services reimbursement or appeals for claim denials should be submitted electronically through our Provider Portal.

If you are unable to log in to the Provider Portal and access your service plan, use the CMS 1500 Health Insurance Claim form to expedite your claim payment. You can access instructions to complete the form and a list of valid service codes.

You will use this paper claim process until you can log in to the Provider Portal and access your service plan. 

To ensure that we have the most up-to-date service plan for our MyCare Ohio members, please fax your service plan to 937-487-0936. This number is only for service plans and NOT claim submissions.

Alternative Method: Paper Claims

For the most efficient processing of your claims, CareSource recommends you submit all claims electronically. Paper claim forms are encouraged only for services that require clinical documentation or other forms to process. Refer to the Provider Manual for instructions to submit paper claims.

Note: Providers are highly encouraged to upload paper claims via the Provider Portal.