Past Updates & Announcements

We strive to make partnering with us simple. We’re aware things may change in the way we do business with you and want to communicate these changes to you in an efficient manner.

Visit the Updates & Announcements page frequently to find all the latest CareSource news. We share updates regarding:

  • Pharmacy information, including our Preferred Drug Lists (PDLs)
  • Medical, pharmacy, reimbursement and administrative policies
  • Authorization requirements as communicated through network notifications below 

The links below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

2022Date
Navigate Extended Payment Plan or Settlement–This notification is an update to the network notification posted on 6/07/202212/22/2022
Navigate Synagis Prior Authorization Resources Notification12/19/2022
Navigate Prior Authorization Requirement for Non-Participating Laboratory Services12/13/2022
Navigate Pharmacy Policy Updates - January 202312/09/2022
Navigate Unified Preferred Drug List (UPDL) Changes12/07/2022
Navigate Policy Updates December 202212/01/2022
Navigate CareSource and TurningPoint Partnership for Cardiac and Musculoskeletal Surgical Procedures - UPDATE11/30/2022
Navigate Program Delay: Phase 3 Launch of ODM Next Generation Managed Care11/18/2022
Navigate Provider Alternative Format Request11/10/2022
Navigate Next Generation December 1 Launch: Training and Resources–This notification is an update to the network notification posted on 01/05/202311/1/2022
Navigate Policy Updates November 202211/1/2022
Navigate CareSource and TurningPoint Partnership for Cardiac and Musculoskeletal Surgical Procedures10/01/2022
Navigate Policy Updates October 202210/01/2022
Navigate OH MCD - October 2022 Versant Vision Policies Updates10/01/2022
Navigate Prescribing Exemption for Antidepressants and Atypical Medication Notification10/01/2022
Navigate Q4 Live Instructor-Led Provider Training and Education Series10/01/2022
Navigate Centralized Credentialing and PNM Portal Overview10/01/2022
Navigate Quarter 2 Avalon Medical Policy Update10/01/2022
Navigate Next Gen Managed Care Program: Do You Have Your OH|ID?09/30/2022
Navigate Preregister for the New PNM Module!09/23/2022
Navigate Ohio Medicaid Single Pharmacy Benefit Manager (SPBM)09/23/2022
Navigate Managed Care Claim Billing for Pharmaceuticals09/22/2022
Navigate Extended Payment Plan or Settlement This notification is an update to the network notification posted on 6/07/202209/13/2022
Navigate Pharmacy Policy Updates - October 202209/12/2022
Navigate October 2022 Provider Orientation and Education Live Webinar Invitation09/12/2022
Navigate The Ohio Department of Medicaid (ODM) Next Generation Program - Provider Updates for October 1 Launch09/06/2022
Navigate Policy Updates September 202209/01/2022
Navigate CLIA-Waived Tests Update08/22/2022
Navigate BH Provider Service Resolution Process Summary08/19/2022
Navigate Provider Alternative Format Request08/16/2022
Navigate Billing Update Re: Multiple Outpatient Claims08/15/2022
Navigate Life Services Referral Form08/12/2022
Navigate Billing Update: Incorrect Billing of Modifier 58 Notification08/10/2022
Navigate Quarter 1 2022 Avalon Medical Policy Update08/01/2022
Navigate Next Generation of Ohio Medicaid Managed Care: Payer ID Change This notification has been revised. See notification dated 1/31/2023.08/01/2022
Navigate Policy Updates August 202208/01/2022
Navigate Next Generation of Managed Care: FQHC/RHC Prior Authorizations and Claims07/27/2022
Navigate Policy Updates - July 202207/21/2022
Navigate Ohio Medicaid Next Generation Program Provider Training Available07/20/2022
Navigate CareSource Live Instructor-Led Provider Training and Education Series07/07/2022
Navigate Pharmacy Policy Updates - July 202207/01/2022
Navigate Quarter 3 & 4 Avalon Medical Policy Update06/30/2022
Navigate We Want to Hear from You!06/30/2022
Navigate OhioRISE Launch: What Providers Need to Know06/27/2022
Navigate Extended Payment Plan or Settlement06/07/2022
Navigate Upload Claim Submissions Seamlessly in Provider Portal06/01/2022
Navigate Policy Updates June 202206/01/2022
Navigate Quarter 2 Avalon Medical Policy Update05/31/2022
Navigate Quarter 2 Avalon Reimbursement Policy Update05/31/2022
Navigate Group Prenatal Care05/23/2022
Navigate Lactation Consultants and Services05/23/2022
Navigate Post-Acute Care Prior Authorization Resumption05/11/2022
Navigate Policy Updates - May 202205/01/2022
Navigate June 2022 Provider Orientation Webinar Registration04/25/2022
Navigate Nurse Home Visit Launch04/25/2022
Navigate VaxCare LARC Inventory Platform04/12/2022
Navigate BH OAHP Readmission Policy04/12/2022
Navigate Billing Updates: Duplicate Discharge Day Management/ICD-10 7th Character and Therapy Proposal04/01/2022
Navigate Benefits of School-Based Health Centers for Ohio Students04/01/2022
Navigate Policy Updates - April 202204/01/2022
Navigate Pharmacy Policy Updates - April 202204/01/2022
Navigate Introducing Teladoc, CareSource’s New Telehealth Partner03/29/2022
Navigate Billing Updates: Chiropractic Unbundling and Duplicate Anesthesia03/23/2022
Navigate Quality Patient Experience Guide (CAHPS resource)03/18/2022
Navigate Maternal and Infant Support Program (MISP) update03/16/2022
Navigate Retro Authorization Submission Guidelines03/15/2022
Navigate Billing Update: Auxiliary Personnel - POS03/14/2022
Navigate Report of Pregnancy and Prenatal Risk Assessment Form Payment Update03/04/2022
Navigate Policy Updates March 202203/01/2022
Navigate Provider Portal Account Linking Enhancement02/21/2022
Navigate Policy Updates February 202202/01/2022
Navigate Annual Update - International Classification of Diseases, 10th Revision, Diagnosis Codes (ICD-10-CM)01/27/2022
Navigate NICU Authorization Process Update01/26/2022
Navigate Transportation Scheduling Now Available01/26/2022
Navigate Provider CLIA HCPCS Code Update01/01/2022
Navigate Policy Updates January 202201/01/2022
2021Date
Navigate 2021 Quarter 3 Provider Portal Updates12/31/2021
Navigate CareSource RxInnovations Ohio Medicaid Claims Processing Updates12/31/2021
Navigate 2021 Global Quality Enhancer: Value-Based Reimbursement Program12/29/2021
Navigate Clarification on Dental Electronic Payment Process Change12/28/2021
Navigate Continuous Glucose Monitor (CGM) Medical Benefit Change – UPDATE12/15/2021
Navigate Notice of Philips Respironics Voluntary Medical Device Recall - UPDATE12/15/2021
Navigate Additional Policy Updates December 202112/15/2021
Navigate ABA Provider Contracting & Credentialing Requirements12/15/2021
Navigate You’re Invited! CareSource Provider Webinar12/13/2021
Navigate Prior Authorization Requirement for Non-Participating Laboratory Services12/10/2021
Navigate Policy Updates December 202112/01/2021
Navigate ABA Claims Paying at Reduced Rate11/19/2021
Navigate Importance of the flu vaccination11/16/2021
Navigate Continuous Glucose Monitor (CGM) Medical Benefit Change11/15/2021
Navigate Policy Updates November 202111/01/2021
Navigate National Provider Identifier for Ordering, Referring and Prescribing Providers – UPDATE10/25/2021
Navigate HIPAA CORE Compliant Codes10/15/2021
Navigate Additional Policy Updates October 202110/15/2021
Navigate 2021-2022 Respiratory Syncytial Virus (RSV) Season and Synagis® Criteria10/13/2021
Navigate Policy Updates October 202110/01/2021
Navigate New Laboratory Benefit Management Program10/01/2021
Navigate Pfizer Vaccine Adherence in Kids (VAKs)09/24/2021
Navigate Hospice Claims Billing Guidance09/20/2021
Navigate Additional Policy Updates September 202109/17/2021
Navigate You’re Invited! CareSource Provider Webinar09/15/2021
Navigate Notice of Philips Respironics Voluntary Medical Device Recall - This notification has been revised. See notification dated 12/15/202109/13/2021
Navigate Additional Policy Updates September 202109/02/2021
Navigate Save the Date: Upcoming Provider Orientation Webinar09/02/2021
Navigate Policy Updates September 202109/01/2021
Navigate CareSource-Akron Pediatric Accountable Care Organization08/31/2021
Navigate Additional Policy Updates August 202108/12/2021
Navigate National Provider Identifier Requirement08/09/2021
Navigate Additional Policy Updates July 202108/03/2021
Navigate Policy Updates August 202108/01/2021
Navigate Waiver National Provider Identifier Requirement – UPDATE07/29/2021
Navigate You’re Invited! CareSource Provider Webinar07/22/2021
Navigate Non-Participating Provider Reimbursement Policy Update07/15/2021
Navigate Pharmacy Prior Authorization Provider Portal Enhancement07/13/2021
Navigate Electronic Visit Verification (EVV) Billing Guidance07/12/2021
Navigate Update in 90 Day Supply Drug List07/01/2021
Navigate Policy Updates July 202107/01/2021
Navigate CMS Interoperability06/22/2021
Navigate You’re Invited! CareSource Provider Webinar06/09/2021
Navigate Updates to Assist with Avalon Laboratory Benefit Management Transition06/04/2021
Navigate We Want to Hear From You!06/03/2021
Navigate Enteral Billing Updates06/01/2021
Navigate Policy Updates June 202106/01/2021
Navigate Save the Date: Upcoming Provider Orientation Webinar05/24/2021
Navigate Utilization Management Process05/18/2021
Navigate CareSource Partnership with Avalon Healthcare for Laboratory Benefit Management05/13/2021
Navigate Additional Policy Updates May 202105/06/2021
Navigate National Provider Identifier Needed – This notification has been revised. See notification dated 07/29/2021.05/06/2021
Navigate Policy Updates May 202105/01/2021
Navigate New Transportation Vendor04/30/2021
Navigate Prior Authorization Updates04/28/2021
Navigate UPDATE - Prior Authorization Requirements04/26/2021
Navigate National Provider Identifier for Ordering, Referring and Prescribing Providers – This notification has been revised. See notification dated 10/25/2021.04/14/2021
Navigate Policy Updates April 202104/01/2021
Navigate Ohio Medicaid Number Mandatory Requirement03/31/2021
Navigate Transplant Services Reimbursement Update03/11/2021
Navigate Policy Updates March 202103/01/2021
Navigate Equian Process Frequently Asked Questions02/18/2021
Navigate Community Behavioral Health Center Re-Credentialing Process02/16/2021
Navigate Annual Notification of Requirements02/12/2021
Navigate Provider Directory Changes for Optometry Service Providers Not Contracted with Superior Vision02/10/2021
Navigate 2020 Quarter 4 Provider Portal Updates02/01/2021
Navigate Policy Updates February 202102/01/2021
Navigate Update in Blood Glucose Meter and Test Strip Preferred Products01/18/2021
Navigate Care Coordination Information Exchange01/18/2021
Navigate Elective Transplant Process Change01/08/2021
Navigate Requirements for Preadmission Screening and Resident Review (PASARR) Process01/01/2021
Navigate Policy Updates January 202101/01/2021
2020Date
Navigate UPDATE - Prior Authorization Requirements12/31/2020
Navigate Transplant Services Reimbursement12/30/2020
Navigate Introducing New Prior Authorization Procedure Code Look-Up Tool12/17/2020
Navigate SolarWinds Cyberattack12/16/2020
Navigate Cotiviti Payment Enhancement Notification12/15/2020
Navigate Announcing Innovative Partnerships for Pediatric Care12/09/2020
Navigate Nursing Facility Assessment Tool12/09/2020
Navigate Mandatory Medicaid Number Requirement12/04/2020
Navigate 2021 Prior Authorization List Reminder12/01/2020
Navigate Policy Updates December 202012/01/2020
Navigate Definitive Urine Drug Testing Billing Update11/30/2020
Navigate Enhanced Services11/20/2020
Navigate ACT/IHBT Disenrollment Expectations11/17/2020
Navigate CareSource Cultural Competency Training11/17/2020
Navigate 2020-2021 Respiratory Syncytial Virus (RSV) Season and Synagis<sup>®</sup> Criteria11/04/2020
Navigate Policy Updates November 202011/01/2020
Navigate Quarter 3 Provider Portal Updates10/28/2020
Navigate Retrospective Eligibility Timeframe Change10/28/2020
Navigate 2020 Quarter 2 Provider Portal Updates10/05/2020
Navigate Policy Updates October 202010/01/2020
Navigate Claim Payment Advice (835) Enhancements09/23/2020
Navigate Emergency BH Hospitalization Initial Medical Necessity Reviews09/22/2020
Navigate Home Health Value Code Requirement09/16/2020
Navigate DentaQuest Transition of Care Reminder09/10/2020
Navigate Claim Remittance Delay09/03/2020
Navigate Enhanced Claim Editing Implementation09/01/2020
Navigate Policy Updates September 202009/01/2020
Navigate Transition of Care Update08/17/2020
Navigate Policy Updates August 202008/01/2020
Navigate 2020 Global Quality Enhancer Program07/31/2020
Navigate Enhancements to Prior Authorizations on Provider Portal – UPDATE07/27/2020
Navigate Opioid Treatment Program Nasal Narcan Billing Guidance07/24/2020
Navigate Durable Medical Equipment Billing Resource Tool07/23/2020
Navigate Provider Directory Information Attestation07/22/2020
Navigate Updates to Ohio Medicaid Prior Authorization List07/17/2020
Navigate Risk Adjustment Coding Education07/15/2020
Navigate CBHC Maximum Units Claim Denials07/13/2020
Navigate Policy Updates July 202007/01/2020
Navigate Interactive Voice Response (IVR) Enhancements for Providers06/25/2020
Navigate Feedback Requested: SNF Provider Summit Ideas06/22/2020
Navigate Provider Portal Claims Submittal Enhancement06/15/2020
Navigate Policy Updates June 202006/01/2020
Navigate Holiday Claim Remittance Delays05/19/2020
Navigate DME Code Edits – UPDATE05/15/2020
Navigate Risk Adjustment Education05/14/2020
Navigate Medical Optometry Claims Processing05/06/2020
Navigate Policy Updates May 202005/01/2020
Navigate Notice of DentaQuest Dental Plan Administration Date Change – UPDATE04/30/2020
Navigate Provider Portal Claims Quick Start Guide – UPDATE04/29/2020
Navigate Completing a Well Visit During a Sick Visit04/20/2020
Navigate Substance Use Disorder Residential Claim Denials – UPDATE04/20/2020
Navigate Designation of Availity as Exclusive EDI Gateway04/15/2020
Navigate Substance Use Disorder Residential Claim Denials – This notification has been revised. See notification dated 04/20/2020.04/13/2020
Navigate Correct Payer ID for Claims Submissions04/06/2020
Navigate Social Determinants of Health Simulation Training04/03/2020
Navigate Notice of DentaQuest Dental Plan Administration Implementation Date Change – This notification has been revised. See notification dated 04/30/2020.04/01/2020
Navigate Policy Updates April 202004/01/2020
Navigate Site of Care Policy Update04/01/2020
Navigate Policy Updates February 2020 – UPDATE04/01/2020
Navigate Recent Provider Portal Updates03/30/2020
Navigate FQHC and RHC Provider Billing Reminder03/27/2020
Navigate Therapy Provider Credentialing Change03/24/2020
Navigate Transition of Care Extended for Superior Vision03/18/2020
Navigate Issue Resolution: Electronic Remittance Advice (ERA) PLB and Claim Level Adjustments03/13/2020  
Navigate Provider Portal Quick Start Guide – This notification has been revised. See notification dated 04/29/2020.03/11/2020
Navigate Consent Forms Reminder03/05/2020
Navigate Access and Availability Standards03/02/2020
Navigate Policy Updates March 202003/01/2020
Navigate Notice of DentaQuest Dental Plan Administration Implementation Date Change – This notification has been revised. See notification dated 04/30/2020.02/20/2020
Navigate Annual Notice of Requirements02/19/2020
Navigate Prenatal Risk Assessment Forms02/18/2020
Navigate Electronic Visit Verification Correction02/18/2020
Navigate Behavioral Health Revenue Code Guidelines02/13/2020
Navigate Provider Transition Fill Correction02/10/2020
Navigate Instructions on Attaching Medical Records in Provider Portal02/07/2020
Navigate Avastin Claims Denied Incorrectly02/07/2020
Navigate Policy Updates February 2020 – This notification has been revised. See notification dated 04/01/2020.02/01/2020
Navigate Notice of DentaQuest Dental Plan Administration  – This notification has been revised. See notification dated 04/30/2020.01/31/2020
Navigate Additional Policy Updates January 202001/28/2020
Navigate Recent Provider Portal Updates01/28/2020
Navigate Paper Checks Dated 1/21, 1/22, 1/2301/27/2020
Navigate EAPG Claims Status01/22/2020
Navigate Payment for Laboratory Services Furnished by FQHCs or RHCs01/21/2020
Navigate Policy Updates January 2020 – UPDATE01/20/2020
Navigate Register with Superior Vision01/16/2020
Navigate Additional Policy Updates January 202001/16/2020
Navigate Dental Providers May Disregard ECHO Health Registration Notification01/14/2020
Navigate Provider Payment Migration Complete01/13/2020
Navigate Dental Claims01/07/2020
Navigate High Dollar Claims Cover Sheet – UPDATE01/07/2020
Policy Updates January 2020 – This notification has been revised. See notification dated 01/20/2020.01/01/2020
2019Date
Navigate Guidelines for Properly Reporting Billing Provider Address12/26/2019
Navigate Pharmacy Network Change (Walgreens)12/11/2019
Navigate Claim Coding Edits – This notification has been revised. See notification dated 05/15/2020.12/04/2019
Navigate Register with New Payment Partner ECHO Health by December 13 – Deadline Extended Again!12/02/2019
Navigate Policy Updates December 201912/01/2019
Navigate Holiday Claim Remittance Delay11/26/2019
Navigate ICD-10 Code Update11/26/2019
Navigate New Primary Care Provider (PCP) Change Request Form11/14/2019
Navigate Delay in Claim Payments11/13/2019
Navigate Important Provider Billing Address Reminder11/05/2019
Navigate Policy Updates November 201911/01/2019
Navigate Ohio Medicaid Unified PDL Announcement11/01/2019
Navigate Dual-Eligibility Billing Reminder10/31/2019
Navigate Policy Updates October 201910/01/2019
Navigate Register with New Payment Partner ECHO Health by December 1 – This notification has been revised. See notification dated 12/02/201909/25/2019
Navigate Recent Provider Portal Updates – UPDATED 10/309/23/2019
Navigate National Provider Identifier for Ordering, Referring, and Prescribing Providers09/10/2019
Navigate Important Inpatient Covered Days Billing Reminder09/10/2019
Navigate Consent Form Upload Enhancement to the Provider Portal – UPDATE09/05/2019
Navigate Enhancements to Prior Authorization on Provider Portal – This notification has been revised. See notification dated 07/27/2020.09/05/2019
Navigate September 2019 Policy Updates09/01/2019
Navigate SUD Partial Hospital Program (PHP)08/27/2019
Navigate Durable Medical Equipment (DME) Recoveries08/26/2019
Navigate Wound Vac (A7000) Requiring Authorization in Error08/23/2019
Navigate Issue with Denials for Physical Therapy (PT) Units08/23/2019
Navigate Issues with Outpatient Claim Denials Due to Authorizations Expiring08/23/2019
Navigate Provider Dispute Process – UPDATE08/16/2019
Navigate Policy Update August 201908/15/2019
Navigate Community Behavioral Health Claim Issue Trends and Guidance08/14/2019
Navigate Electronic Visit Verification Update08/09/2019
Navigate SUD Residential Treatment Policy Update08/09/2019
Navigate 2019-2020 Ohio Provider Manual Now Available08/06/2019
Navigate Policy Updates August 201908/01/2019
Navigate Register with New Payment Partner ECHO Health by October 25 – This notification has been revised. See notification dated 09/25/201907/26/2019
Navigate Reminder – Authorization Requirements for Ancillary Providers07/22/2019
Navigate Coordination of Benefits (COB) Reminder07/22/2019
Navigate Duplicate Modifier on the Claim Service Line07/17/2019
Navigate Post-Payment Audit Update07/12/2019
Navigate Provider Dispute Process – This notification has been revised. See notification dated 08/16/201907/05/2019
Navigate Policy Updates July 201907/01/2019
Navigate Multi-Factor Authentication Scheduled for SKYGEN CWP06/21/2019
Navigate Policy Updates June 201906/17/2019
Navigate Dental Code D9230 Payment Policy Update06/14/2019
Navigate Dental Sedation Codes Payment Policy Reminder06/14/2019
Navigate Non-Covered Dental Service Code Payment Policy Reminder06/14/2019
Navigate Prior Authorization Enhancements for Observation Stays06/13/2019
Navigate 2019 Dental Procedure Code Updates06/10/2019
Navigate Electronic Visit Verification Training Update06/10/2019
Navigate Inpatient Hospital Pre-payment Claims Reviews - Revised 6/6/201906/03/2019
Navigate Policy Updates June 201905/31/2019
Navigate Tips to Improve Pediatric CAHPS Ratings05/29/2019
Navigate End-Stage Renal Disease (ESRD) Claims and Value Code D505/29/2019
Navigate Community Behavioral Health Claim Issue Trends and Guidance05/28/2019
Navigate Designating a Supervising Provider Using Paper Claims05/17/2019
Navigate Upgrades to AHS Consent Form on the Provider Portal05/13/2019
Navigate High Cost Radiology Services/NIA Authorization Denial for Hospitals 05/06/2019
Navigate Electronic Visit Verification Training Update05/06/2019
Navigate Access Standards Update05/06/2019
Navigate Policy Updates May 201905/01/2019
Navigate New Policy Updates  April 201904/12/2019
Navigate Statewide Hepatitis A Outbreak Information04/12/2019
Navigate Applied Behavior Analysis Rates and Pricing04/04/2019
Navigate Policy Updates April 201904/01/2019
Navigate Enhancements to Delivery and Newborn Notifications – UPDATE03/28/2019
Navigate Applied Behavioral Analysis (ABA) Billing and Coding03/27/2019
Navigate Interventions to Prevent Perinatal Depression03/13/2019
Navigate Electronic Visit Verification Training Update03/12/2019
Navigate Provider Portal Survey03/07/2019
Navigate Policy Updates May 201903/01/2019
Navigate High Dollar Claims – This notification has been revised. See notification dated 01/07/202002/19/2019
Navigate Behavioral Health Claim Issue Identified - UPDATE02/19/2019
Navigate Place of Service Code for Claim Submissions02/14/2019
Navigate Revenue Code 0636 Denials Update02/13/2019
Navigate National Drug Code (NDC) with J1050 Denials Update02/08/2019
Navigate Enhancements to Delivery and Newborn Notifications 02/01/2019
Navigate Hepatitis A Prevention01/29/2019
Navigate Diagnosis Related Group (DRG) Validation Audits01/21/2019
Navigate Request Interpreter Services Online01/21/2019
Navigate Issues with Mammogram Benefit Limits01/14/2019
2018Date
Navigate Policy Update March 201912/31/2018
Navigate Claim Denial Issue - Error Code X9412/27/2018
Navigate Notice of Changes to Retro Prior Authorization Timeframe Requirements12/26/2018
Navigate Behavioral Health Claim Issue Identified12/18/2018
Navigate Issues with Claim Denying for National Drug Code (NDC)12/14/2018
Navigate Remittance Delay for Wednesday, December 5, 2018 Payment Cycle12/07/2018
Navigate Policy Updates January 201911/30/2018
Navigate Electronic Visit Verification Reminder11/14/2018
Navigate Policy Updates January 201911/01/2018
Navigate Updated Prior Authorization Requirements for Home Care Services11/01/2018
Navigate Code Advisor Network Notification10/23/2018
Navigate Electronic Provider Appeals Required10/02/2018
 Navigate Policy Updates December 201810/01/2018
Navigate Ambulance Overpayments and Incorrect Payments Recovery09/27/2018
Navigate Q3 2018 Payment Update09/27/2018
Navigate DME Overpayments and Incorrect Payments Recovery Notice09/27/2018
Navigate Home Health Overpayments and Incorrect Payments Recovery Notice09/27/2018
Navigate Physician Assistant Overpayments and Incorrect Payments Recovery Notice09/27/2018
Navigate Duplicate Claim Processing Update09/01/2018
Navigate Clarification on CareSource Medicaid Vision Benefit – UPDATE08/30/2018
Navigate Policy Updates November 201808/28/2018
Navigate Well-Child Care08/27/2018
Navigate ODM Medicaid Number Requirement08/27/2018
Navigate Signatures No Longer Needed for Medicaid Addendum Attachments for Provider Maintenance Updates08/21/2018
Navigate Consent to Share Sensitive Health Information08/08/2018
Navigate Archive Global Obstetrical Services Policy08/01/2018
Navigate Clarification of Indiana Network Closure Communication07/30/2018
Navigate Increasing Claim Payment Processing Frequency – UPDATE07/27/2018
Navigate Policy Updates October 201807/27/2018
Navigate Additional Update on CareSource Medicaid Vision Benefit – This notification has been revised. See notification dated 08/30/2018.07/24/2018
Navigate Trading Partners Administrative Policy07/20/2018
Navigate Inventory Reduction Progress and Issue Reporting07/10/2018
Navigate Increasing Claim Payment Processing Frequency07/03/2018
Navigate New Address for Refund Checks07/03/2018
Navigate Policy Updates September 201806/29/2018
Navigate New Requirement to Report Individual NPIs in Rendering Fields of AHCC, FQHC, FBC, OHF and RHC Claims06/19/2018
Navigate Notification of Claim Adjustments for Certain Edit Codes06/13/2018
Navigate Policy Updates August 201806/12/2018
Navigate Durable Medical Equipment (DME) Update06/08/2018
Navigate Breast Imaging Reimbursement Policy06/05/2018
Navigate Tips to Prevent Payment Delays06/01/2018
Navigate Community Behavioral Health Centers (CBHC) Provider Orientation05/31/2018
Navigate CareSource Secure Email Portal Security Enhancements05/17/2018
Navigate Policy Updates July 201804/19/2018
Navigate Update on CareSource Medicaid Vision Benefit – This notification has been revised. See notification dated 07/24/2018.04/18/2018
Navigate Care Coordination Codes Reminder04/16/2018
Navigate Update to Provider Billing Address Requirements on Claims04/03/2018
Navigate Policy Updates June 201803/30/2018
Navigate 2018 Dental Procedure Code Updates – UPDATE 03/28/2018
Navigate Update to Drug Testing Policy – UPDATE03/12/2018
Navigate Policy Updates May 201802/28/2018
Navigate PY-0436 Sexually Transmitted Infections02/27/2018
Navigate 2018 Dental Procedure Code Updates – This notification has been revised. See notification dated 03/28/2018.02/01/2018
Navigate CareSource No Longer Accepting 77057 Claim Code for Mammography Services01/26/2018
Navigate Diabetes Retinal Eye Exam01/25/2018
Navigate Reminder to Include Gestational Age on Delivery Claims01/24/2018
Navigate New Approach to Educate and Reduce Evaluation and Management Billing Errors01/08/2018
2017Date
Navigate March 2018 Policy Release12/28/2017
Navigate CareSource Medicaid Vision Benefit – This notification has been revised. See notification dated 04/18/201812/11/2017
Navigate Update on Drug Testing Reimbursement Policy – UPDATE12/01/2017
Navigate Notice of Change to Cardiac Services Prior Authorization Requirements11/17/2017
Navigate Upcoming Deadline for Submitting Ohio Medicaid Provider Number Applications11/17/2017
Navigate Enhanced Ambulatory Patient Groups (EAPG) Billing Methodology Supersedes CareSource Payment Policies11/07/2017
Navigate December 2017 Policy Release11/01/2017
Navigate Diagnosis Related Group Rate Changes10/24/2017
Navigate Update Regarding Enhanced Ambulatory Patient Group (EAPG) Billing Payment Methodology10/10/2017
Navigate November 2017 Policy Release09/28/2017
Navigate PY-0101 - Genetic Testing- Polymerase Chain Reaction09/22/2017
Navigate Clinical Appeals Require Member Consent09/22/2017
Navigate Update on Processing Claims for Enhanced Ambulatory Patient Groups – UPDATE09/01/2017
Navigate Drug Screening Reimbursement Policy – This notification has been revised. See notification dated 12/01/2017.08/30/2017
Navigate Update on Claim Configurations for Genetic Testing - Polymerase Chain Reaction – UPDATE08/17/2017
Navigate Update on Claim Configurations for Genetic Testing - Polymerase Chain Reaction – This notification has been revised. See notification dated 08/17/2017.08/14/2017
Navigate PY-0020 - Drug Screening Payment Policy – This notification has been revised. See notification dated 08/30/2017. 07/31/2017
Navigate Announcing Enforcement of Enhanced Ambulatory Patient Groups Billing Guidelines – This notification has been revised. See notification dated 09/01/2017.07/27/2017
Navigate September 2017 Policy Release07/27/2017
Navigate Update on Behavioral Health Denials for Code X5007/26/2017
Navigate Behavioral Health Respite Care Services for Children07/18/2017
Navigate Blood Lead Testing Recommendations07/05/2017
Navigate Update on Configurations for Sexually Transmitted Infections Claims06/23/2017
Navigate July 2017 Policy Releases05/31/2017
Navigate Retro Prior Authorizations05/31/2017
Navigate PY-0037, PY-0205 Sexually Transmitted Infections Reimbursement Policy04/19/2017
Navigate Screening and Surveillance for Colorectal Cancer04/18/2017
Navigate MM-0034, MM-0079, MM-0080 Gender Dysphoria Medical Policy04/14/2017
Navigate PY-0206 Hepatitis Panel Payment Policy04/13/2017
Navigate Update on Claim Configurations for Specialty Codes and Durable Medical Equipment04/13/2017
Navigate PY-0128 Three-Day Window Payment Policy04/10/2017
Navigate Cite AutoAuth – Inpatient PA Requests04/03/2017
Navigate PY-0226, PY-0227, PY-0228 Vitamin D Assay Testing Payment Policy03/31/2017
Navigate PY-0222, PY-0223, PY-0224 Thyroid Testing Payment Policy03/31/2017
Navigate PY-0181, PY-0185, PY-0187 Transthoracic Echocardiogram Payment Policy03/31/2017
Navigate PY-0169, PY-0174, PY-0173 Sleep Studies Payment Policy03/31/2017
Navigate PY-0163, PY-0167, PY-0168 Non-Invasive Vascular Studies Payment Policy03/31/2017
Navigate PY-0157 Glycosylated Hemoglobin A1C Payment Policy03/29/2017
Navigate PY-0001 Global Obstetrical Services Payment Policy03/29/2017
Navigate PY-0084 Telemedicine Services Payment Policy03/29/2017
Navigate PY-0004 Preferred Obstetrical Services Payment Policy03/29/2017
Navigate PY-0020 Drug Screening Payment Policy – This notification has been revised. See notification dated 08/30/2017.03/20/2017
Navigate Home Health Nursing Code Change03/15/2017
2016Date Posted
Navigate Quick Reference Guide for Non-Participating Health Partners – UPDATE11/02/2016
Navigate Change in OAC and National Medicaid Code Edits09/09/2016
Navigate Podiatry 10-Day Quantity Limit for Prescribing Opioids09/08/2016
Navigate New Genetic Testing - Polymerase Chain Reaction Payment Policy08/25/2016
Navigate Cite AutoAuth Expansion for Inpatient Authorizations08/23/2016
Navigate Updated Sexually Transmitted Infection Policy08/19/2016
Navigate Updated Interventional Pain Mgt Policies08/19/2016
Navigate Zika Virus Benefit Summary08/19/2016
Navigate Updated EPSDT Claim Acceptance Criteria07/28/2016
Navigate Suspension of EPSDT Claim Submission Criteria07/22/2016
Navigate 10-Day Quantity Limit for Prescribing Opioids07/11/2016
Navigate Notice of Medical Documentation Requirement for Claim Modifiers06/14/2016
Navigate Spring 2016 Health Partner Education Forums04/22/2016
Navigate Change in LCD Procedure Code Edits – UPDATE04/14/2016
Navigate Update on Appropriate Use of G Codes03/31/2016
Navigate Home Infusion Therapy Prior Authorization Requirements, Pharmacy Criteria and Billing Guidelines03/25/2016
Navigate Curbing Opioid Overdose with Naloxone – UPDATE03/14/2016
Navigate Paper Claims Processing: Rendering and Billing NPI Requirements03/07/2016
Navigate Change in LCD Procedure Code Edits – This notification has been revised. See notification dated 04/14/2016.03/04/2016
Navigate Update on Billing Guidelines for Healthchek (EPSDT) Claims02/26/2016
Navigate Additional Dental Handbook Updates for 201602/03/2016
Navigate Deadline Extended for Healthchek (EPSDT) Claims Processing Guidelines01/29/2016
Navigate Change in Behavioral Health Clinical Guidelines01/20/2016
New Facility Code Edits for Claims – This notification was canceled and removed 03/03/2016.01/07/2016
2015Date
Posted
Navigate Healthchek (EPSDT) Claims Processing Guidelines12/31/2015
Navigate MyCare Coordination of Benefits (COB) Change12/18/2015
Navigate Vision Benefit Change (Transitions Lenses)12/04/2015
Navigate Dental Handbook Updates for 201612/01/2015
Navigate Vision Benefit Change Update11/18/2015
Navigate Health Partner Network Notification11/17/2015
Navigate ICD-10 Qualifiers11/12/2015
Navigate Curbing Opioid Overdose with Naloxone – See notification dated 03/14/2016.11/03/2015
Navigate Improved Provider Directory! Your help is needed!10/29/2015
Navigate Quick Reference Guide for Non-Participating Providers – This notification has been revised. See notification dated 11/02/2016.10/27/2015
Navigate Credentialing Process10/19/2015
Navigate Vision Benefit Change – See notification dated 11/18/2015.09/29/2015
Navigate ICD-10 Coding Guidelines Available from CMS09/16/2015
Navigate Getting Ready for ICD-1009/09/2015
Navigate New Facility Code Edits for Claims09/03/2015
Navigate CMS Posts ICD-10-CM and PCS Code Lists08/13/2015
Navigate CMS and AMA Issue FAQs to Clarify ICD-10 Preparation Guidance08/06/2015
Navigate Notification of Nurse & Aide Service Rate Modernization Changes08/03/2015
Navigate Healthcare Clinic at Select Walgreens Now Accepting CareSource Members07/28/2015
Navigate New Requirements for Corrected Claims Submissions Effective August 20, 201507/22/2015
Navigate CMS Creates Countdown Video, Infographic to Ease ICD-10 Transition07/22/2015
Navigate HealthSpot Locations Open for Ohio Medicaid Members – This notification was rescinded 12/31/15.07/15/2015
Navigate Home Health and Hospice ICD-10 Coding Training Opportunity07/15/2015
Navigate CMS and AMA Partner on ICD-10 Preparations07/10/2015
Navigate CMS Case Studies Available to Explore ICD-10 Concepts06/11/2015
Navigate CareSource Webinar, CMS Videos and Call Available for ICD-10 Prep06/04/2015
Navigate Submit Claims Online Through Provider Portal06/01/2015
Navigate ODM offers ICD-10 Coding Practice Opportunity05/21/2015
Navigate ICD-10 Readiness Assessment05/14/2015
Navigate Summary of MyCare Ohio Services Requiring Prior Authorization05/12/2015
Navigate Revised Clinical Supporting Documentation Policy05/06/2015
Navigate Road to 10 Resource for ICD-10 Implementation04/30/2015
Navigate Transition of Care (TOC) for MyCare Extended for Community Mental Health Centers (CMHCs)04/23/2015
Navigate Pediatric Clinical Guideline04/15/2015
Navigate Cite Auto Auth04/13/2015
Navigate Prior Authorization for Pain Management and CPAPs04/08/2015
Navigate Primary Care Rate Increase (PCRI) Ending04/08/2015
Navigate ICD-10 Webinars Scheduled04/06/2015
Navigate ICD-10 Transition Tips03/30/2015
Navigate Updated Health Partner Dental Handbook Now Online03/03/2015
Navigate 2015 Ohio Provider Manual Now Available02/23/2015
Navigate Office of Health Transformation Payment Innovation02/20/2015
Navigate EDI Submission of Corrected Claims02/16/2015
Navigate Electronic Submission of Coordination of Benefits (COB) Claims02/12/2015
Navigate MyCare Coordination of Benefits (COB) Change for Specific Provider Types02/06/2015
Navigate MyCare Explanation of Payment (EOP) Correction01/30/2015
Navigate CareSource Dental Provider Updates01/23/2015
Navigate MyCare Bad Debt Reports01/15/2015
2014Date
Posted
Navigate ALERT: ICD-10 Transition Webinar12/15/2014
Navigate UPDATE – ICD-10 Training Needs and Provider Checklist11/07/2014
Navigate Text4Baby Service Launches for Ohio Medicaid Members10/28/2014
Navigate MyCare Ohio Enrollment Changes10/14/2014
Navigate ALERT: MITS Scheduled Downtime October 10 6PM until October 14 6AM10/08/2014
Navigate Apria Terming as DME Provider10/03/2014
Navigate CareSource Advantage (HMO SNP) Non-Renewal10/01/2014
Navigate State of Ohio Clarifies FQHCs, RHCs not Eligible for PRCI09/29/2014
Navigate 7 Day Follow-up After Hospitalization for Mental Illness09/19/2014
Navigate Update on Autism in Ohio08/20/2014
Navigate Primary Care Rate Increase Update08/13/2014
Navigate MyCare Educational Forums08/01/2014
Navigate Coordination of Dental/Orthodontics Benefits07/18/2014
Navigate Ohio Medicaid Pregnancy Test Kit Initiative07/16/2014
Navigate New Online Interactive Health Risk Assessment for OH Medicaid and CareSource Just4Me Members07/01/2014
Navigate OH Medicaid Vision Benefit Update06/24/2014
Navigate Claims Processing: Rendering Provider NPI Requirement04/08/2014
Navigate Fee Schedule Resources and Links04/08/2014
Navigate ICD-10 Implementation Delayed One Year04/07/2014
Navigate Reminder to Refer to Participating Providers03/19/2014
Navigate ICD-10 OH Medicaid Provider Q&A03/05/2014
Navigate Influenza CPT Coding Change02/21/2014
Navigate ICD-10 Provider Readiness Assessment Survey01/30/2014
Navigate Change to DRG Payment Process01/17/2014
Navigate New CMS-1500 Claim Form01/03/2014
2013Date
Posted
Navigate SNP Prior Authorization High Tech Radiology12/31/2013
Navigate Enhanced Primary Care Payment12/20/2013
Navigate CareSource Just4Me Resources Available on www.caresource.com12/19/2013
Navigate ICD-10 OH Medicaid Provider Q&A12/13/2013
Navigate Americans with Disabilities Act (ADA) Compliance12/12/2013
Navigate Screening, Brief Intervention, and Referral to Treatment (SBIRT)12/06/2013
Navigate NEW CareSource Provider E-Communication System11/21/2013
Navigate New Facility Code Edits for Hospital Claims11/14/2013
Navigate Quick Reference Guide for Non-Participating Providers10/21/2013
Navigate ICD-10 Training Needs and Provider Checklist10/17/2013
Navigate Synagis Prior Authorization Procedure10/02/2013
Navigate Provider Issue Resolution Process09/04/2013
Navigate Fibromyalgia Medication Cost Comparison08/21/2013
Navigate Payment Policies Page Added to www.caresource.com07/31/2013
Navigate ICD-10 Compliance Requirement effective October 1, 201407/12/2013
Navigate Credentialing of Physician Assistants (PAs) and Advanced Practice Nurses (APNs)07/11/2013
Navigate Health Services Advisory Group (HSAG) Survey Calls06/24/2013
Navigate Five Things to Know About Ohio Medicaid Changes06/21/2013
Navigate Specialty Pharmacy Network Reduction05/20/2013
Navigate Online Drug Formulary Search Tool05/08/2013
Navigate Pharmacy Tips: Go Generic!05/07/2013
Navigate Provider Information Maintenance Reminder04/02/2013
Navigate Short Fill for Oncology Medications, Phase 203/29/2013
Navigate Fluoride Varnish Application Code Change03/20/2013
Navigate Additional Requirements for Fixed Wing and Helicopter Air Ambulance Operators03/15/2013
Navigate Short Fill for Oncology Medications03/05/2013
Navigate CareSource Available on Availity Portal01/23/2013
Navigate Outpatient Facility Claims and Requirements of Modifier 2501/31/2013

2012Date
Posted
Navigate OutcomesMTM Provides Medication Therapy Management Services for CareSource Advantage – Effective 01/01/1312/27/12
Navigate CareSource Policy on Co-Surgeons and Modifier -62 Billing and Reimbursement12/10/12
Navigate CareSource Policies on Facet Joint and/or Joint Nerve Injection and Sacro-iliac Joint Injection12/03/12
Navigate Non-Par Provider Quick Reference Guide11/29/12
www.caresource.com is all NEW!11/26/12
Changes to CareSource Coordination of Benefits (COB) Policy – Effective 11/05/1211/05/12
Termination of CareSource Advantage Contract; Continuation of CareSource Medicaid Contracts11/02/12
CareSource Receives NCQA Accreditation11/02/12
Enhanced Dental Management Portal Functionality and Claims Processing – Effective 11/26/1210/26/12
Claims Payment and New EFT Enrollment Authorization Agreement Form – Effective 11/26/1210/26/12
CareSource Now Available on Availity® Portal10/22/12
Dental Claims Payment and New EFT Enrollment Authorization Agreement Form10/19/12
CareSource Policy regarding CMS NCD/LCD Policies10/16/12
Enhanced Providers Who Administer Synagis® (palivizumab) – Effective 11/01/1210/09/12
Enhanced Dental Management Services and Upcoming Educational Webinars10/02/12
Electronic Submission of Coordination of Benefits (COB) Claims – Effective 09/17/1209/17/12
Navigate Post Stabilization Care Services09/10/12
Easier-to-Use Membership Lists on the Provider Portal09/07/12
Provider Access Standards – Reminder08/15/12
Outpatient Reimbursement, Revenue Codes 250, 270, 636 – Effective 08/01/1207/31/12
Provider Satisfaction Survey – Coming in September07/27/12
New Medication Therapy Management Program07/13/12
ODJFS J Codes Covered for ODMH and ODADAS Providers07/11/12
CareSource Facility Surgical Edit Policy – Rescinded in 2013, see Anesthesia Payment Policy07/11/12
CareSource Contracting and Credentialing of Physician Assistants07/11/12
New Coordination of Benefits (COB) Policy – Under Revision 10/10/1206/25/12
Members Taking Nexium, Dexilant, Aciphex06/07/12
ODJFS Updated Sterilization and Hysterectomy Forms06/04/12
CareSource Facility Surgical Edit Policy05/31/12
Update on Provider ID Numbers and Legacy ID on Claims04/20/12
NDC Code Requirements for Professional Claims04/06/12
CareSource MUE Lab Code Policy04/10/12
Reminder to Submit Appropriate Provider ID Numbers on 5010 Claims04/06/12
Providers Who Administer Synagis® (palivizumab)04/05/12
A Quick Reference Guide: Improving the Patient Experience04/04/12
Care Transition Programs04/02/12
New Abbott Diabetes Care Program03/23/12
Updated Timely Filing Rules 03/15/12
New Diabetic Supplier – Abbott Laboratories02/14/12
Provider/Group Change Request Form Updated02/03/12
Individual Claim Payment of $500,000 and Higher01/31/12
Preferred Specialty Pharmacy Provider01/24/12
Update on 5010 Clearinghouse Claims Transactions and Issues01/20/12
CareSource Pharmacy Policy on Stolen Controlled Substances01/19/12

2011Date
Posted
Navigate Tips for 5010 Success: Submit Legacy ID & Correct Remittance Address12/30/11
Navigate ODJFS/CareSource Reimbursement Changes for 201212/22/11
Navigate Radiation Safety and Most Frequently Requested Advanced Imaging Procedures12/13/11
Navigate New Provider Portal Updates11/22/11
Navigate Pharmacy Transition Period Reminder11/15/11
Revised CareSource Venipuncture Policy10/28/11
Navigate Refraction Policy10/28/11
Navigate Revised Clinical Supporting Documentation Policy10/28/11
Navigate Medically Unlikely Edit (MUE) Policy for code 8834210/28/11
Navigate CareSource Trading Partners Submitting EDI 837 Claims10/25/11
Navigate Providers Who Administer Synagis<sup>®</sup> (palivizumab)10/17/11
Navigate September 26 Check Write Delayed for Paper Checks / EOPs10/07/11
Navigate New Benefit Limits Feature on the CareSource Provider Portal09/30/11
Navigate Quick Reference Guide for Non-Participating Providers09/26/11
Navigate Prescription Drug Coverage Changing for Members of Ohio Medicaid09/16/11
Navigate Elective Labor and Delivery Prior to 39 Weeks Gestation09/08/11
Navigate Enhanced Dental Management Services09/06/11
Navigate Electronic Funds Transfer – Now Available for All Ohio Providers08/12/11
Navigate CareSource Plan for 5010 Transition07/26/11
Navigate Ohio Debarred Attestation07/18/11
Navigate NDC Requirements for Physician Administered Drugs in an Office Setting07/15/11
Navigate Ohio Passes House Bill 93 on Prescription Drug Abuse06/27/11
Navigate 3-day Payment Window for Outpatient Svcs Treated as Inpatient Svcs06/24/11
Navigate Requesting a Contract and Updating Provider Information Changes06/02/11
Trigger Point Injection Policy05/25/11
Navigate Facet Joint and/or Joint Nerve Injection Policy05/25/11
Navigate Epidural Steroid and Selective Transforaminal Epidural Injections05/24/11
Navigate CareSource Medicaid DME and Modifier Policy05/23/11
Navigate ODJFS Supports Electronic Health Records Incentive05/16/11
Navigate PA Changes to Select Specialty Medications and Pain Management Procedures05/16/11
Navigate Enhanced Find a Doctor online search tool05/16/11
Navigate Revised Immunization and Administration Billing Policy05/13/11
Navigate Enhanced Disease Management Program05/2011
Navigate Member Education Strategies on Smoking Cessation04/2011
Navigate New PA Changes to Select Specialty Medications and Pain Management Procedures04/2011
Navigate Clinical Supporting Documentation Policy04/2011
Navigate New Improved Explanation of Payment Form04/2011
Navigate CareSource Plan for 5010 Transition04/2011
Navigate EHR Incentive Program03/2011
Navigate Updated Panel Closure for Select Provider Types: Podiatrists, Chiropractors03/2011
Navigate Therapy Billing - Revised03/2011
Navigate Facility Inpatient Reimbursement – Now Based on Admit Date03/2011
Navigate CareSource Changes Transportation Vendor for Members02/2011
Navigate Advanced Imaging Services Need NIA Privileges02/2011
Navigate Change to Flu Codes for Special Needs Plan (SNP) Members01/2011
Navigate APN Medicare Pricing/CMS Methodology01/2011
Navigate APN Medicaid Pricing/ODJFS Methodology01/2011
Navigate Provider Survey – Going on Now!01/2011
Navigate Modifier Definitions01/2011
Navigate CAHPS Survey Results01/2011
Navigate What Constitutes a Material Change to an Existing Contract01/2011
2010Date
Posted
Navigate Direct Access for Case Management/member needs now 24/712/2010
Navigate Important Reminder on Montgomery County Care Program12/2010
Navigate CareSource Medical Claim Edit z60 – Not a Primary Diagnosis12/2010
Navigate Claim Overpayment Recoupment Policy12/2010
Navigate Multiple Surgery Procedures for Facility and Professional Claim Submissions12/2010
Navigate Claim Reprocessing Policy due to Systemic Errors12/2010
Navigate FDA Withdraws Propoxyphene (Darvocet) from the Market12/2010
Navigate Statewide Coverage for Vision Labs10/2010
Navigate Panel Closure for Select Provider Types10/2010
Navigate Claim Overpayment Recoupment Policy10/2010
Navigate Podiatry Services Policy10/2010
Navigate CareSource Code Editing10/2010
Navigate Reprinted September 11, 2010 Explanation of Payment (EOPs)09/2010
Navigate Timely Filing Revisions08/2010
Navigate Appealing Sterilization Claims08/2010
Navigate Prevnar 13 Reimbursement – Backdated from March 18, 201008/2010
Navigate Member Benefits Based on Calendar Year07/2010
Navigate Professional Developmental Testing Services Billing & Reimbursement Policy07/2010
Navigate Confidential Provider Information and Unsecured Emails07/2010
Navigate Payment Policy for Evaluation & Management Services Provided During Global Surgery Period07/2010
Navigate L-code Changes for 201007/2010
Navigate Advanced Practice Nurses to be Contracted as Primary Care Providers05/2010
Navigate Services Requiring Prior Authorization02/2010
Navigate Top Claim Denials02/2010
Navigate Corrected Claims02/2010
Navigate Hemoglobin and HealthChek Screening Visits02/2010
Navigate Refractive Service Codes02/2010
Navigate Prior Authorization Waived for Skilled Home Visits01/2010