File a Complaint

We hope you will be happy with CareSource and the service we provide. If you are unhappy with anything about CareSource or its providers you should contact us as soon as possible. This includes if you do not agree with a decision we have made. You, or someone you want to speak for you can contact us. If you want someone to speak for you, you will need to let us know this. CareSource wants you to contact us so that we can help you. To contact us, you can:

  • Call Member Services at 1-866-415-0584 (TTY: 1-800-750-0750 or 711); or
  • Fill out the Member Grievance/Appeal Form in your child's Member Handbook; or
  • Call Member Services to request a Member Grievance/Appeal Form be mailed to you; or
  • Write a letter telling us what you are unhappy about. Be sure to put your first and last name, the number from the front of your child's CareSource member ID card, and your address and telephone number in the letter so that we can contact you, if needed. You should also send any information that helps explain your problem.

Mail the form or your letter to:

CareSource
Attn: Grievance Department
P.O. Box 1947
Dayton, OH 45401-1947

CareSource will send you something in writing if we make a decision to:

  • Deny a request to cover a service for your child;
  • Reduce, suspend or stop care your child is already receiving; or
  • Deny payment for a service your child received that is not covered by CareSource.

We will also send you something in writing if, by the date we should have, we did not:

  • Make a decision on whether to okay a request to cover a service for your child; or
  • Give you an answer to something you told us you were unhappy about.

If you do not agree with the decision/action listed in the letter, and you contact us within 90 calendar days to ask that we change our decision/action, this is called an appeal. Unless we tell you a different date, we will give you an answer to your appeal in writing within 15 calendar days from the date you contacted us. You can also appeal by phone or in writing. You can submit information to help explain your case if you want.

If you contact us because you are unhappy with something about CareSource or one of our providers, this is called a grievance. CareSource will give you an answer to your grievance by phone (or by mail if we can't reach you by phone) within the following time frames:

  • 2 working days for grievances about not being able to get medical care
  • 30 calendar days for all other grievances except grievances that are about getting a bill for care your child has received
  • 60 calendar days for grievances about getting a bill for care your child has received

You also have the right at anytime to file a complaint by contacting the:

Ohio Department of Job and Family Services
Bureau of Managed Health Care
P.O. Box 182709
Columbus, Ohio 43218-2709
1-800-605-3040 or 1-800-324-8680
(TTY: 1-800-292-3572)
Ohio Department of Insurance
50 West Town St.
Third Floor, Suite 300
Columbus, Ohio 43215
1-800-686-1526

For more information about filing a complaint, please refer to the CBI Member Handbook .