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Quality Improvement
https://www.caresource.com/providers/education/quality-improvement/...the CareSource Vice President, Quality Improvement and Performance Outcomes. On an annual basis, CareSource makes information available about our Quality Management and Improvement program to providers on our website. CareSource...
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Provider Disputes or Appeals
https://www.caresource.com/providers/provider-portal/appeals/...Fax: 937-531-2398 Phone: 1-833-230-2101 Phone for Expedited Appeals: 1-800-488-0134 Mail: CareSource Attn: Grievance & Appeals Department P.O. Box 2008 Dayton, OH 45401 Expediting Clinical Appeals Per OAC 5160-26-08.4, CareSource shall...
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FAQs
https://www.caresource.com/providers/education/faqs/...the claim as if CareSource was the primary payer. Once the delivery charge is received, CareSource will combine all prenatal visit charges with the delivery charges. CareSource will subtract the...
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Utilization Management
https://www.caresource.com/providers/education/patient-care/utilization-management/...activities. CareSource makes its UM criteria available in writing by mail, fax or phone and on this webpage. CareSource is committed to maintaining the quality and appropriateness of health care...
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COVID-19 Information and Resources
https://www.caresource.com/providers/tools-resources/covid-19-provider-resource-center/The Public Health Emergency (PHE) for COVID-19 has ended. Services like vaccines, treatment, and testing are still available. Some rules changed, stopped, or started again. CareSource continues to watch COVID-19...
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FAQs
https://www.caresource.com/members/education/faqs/...member. Get a CareSource member ID Card, Plan Documents or Change Your Doctor How do I get a new CareSource member ID card? Log into your My CareSource account to...
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Pharmacy
https://www.caresource.com/providers/education/patient-care/pharmacy/...on the Forms page. In emergent situations, requests may be accepted via phone. Phone: 1-855-202-1058 (Phone requests are not for routine prior authorization requests.) Note: All oncology medication treatment regimen...
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Claims
https://www.caresource.com/providers/provider-portal/claims/...for any services rendered to CareSource members, except in emergency situations. CareSource must ensure all providers, including providers with a single case agreement (SCA), are active provider in ODM’s PNM...
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Get Contracted
https://www.caresource.com/producers/get-contracted/...Phone number: (502) 245-1371 Visit Broker Website E-mail: matt@med-link.net Advocate Health Phone number: (941) 473-0800 Visit Broker Website E-mail: advocate-contracting@advocatehealth.com Agent Pipeline Phone number: (304) 755-6400 Visit Broker Website E-mail:...
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Contact Us
https://www.caresource.com/members/contact-us/...want to make it easy to work with us, whether online or over the phone. That’s Health Care with Heart®! Welcome CareSource Members! CareSource marketplace plans provide comprehensive, quality coverage...
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