Claims Payment
Explanation of Payment (EOP)
Explanations of Payment (EOP) are statements of the current status of your claims that have been submitted to CareSource and entered into our system. EOPs are usually generated every week. However, you may not receive an EOP each time they are generated depending on your claims activity.
EOPs include paid and denied claims. Any denied claims appear on the EOP with a message code indicating the reason the claim is unpaid. Providers can resubmit denied claims, as appropriate, with the corrected or completed information needed for processing.
Please note: Non-contracted providers are paid at Michigan Medicaid Fee-for-Service (FFS) rates. Contracted providers are eligible for enhanced reimbursement rates above FFS. If you are interested in becoming a contracted provider, please contact your Provider Relations representative.