Claims Payment

Great News - Electronic Funds Transfer Now Available!

Great news, EFT is now available for all CareSource Ohio Providers!

Benefits of EFT

Simple - Receive fully reconciled remittances electronically; eliminate paper checks and Explanation of Payments (EOPs), which will increase efficiency with payment processing.

Convenient - Available 24/7; works in conjunction with EMR systems. In addition, CareSource offers free training for providers.

Reliable - Claim payments electronically deposited into your bank account.

Secure - Access your account through CareSource's secure Provider Portal to view (and print if needed) remittances and transaction details.

Enroll in EFT

Simply complete the enrollment form and fax it back to InstaMed, who will work directly with providers to enroll in EFT. Free EFT training is also available to CareSource providers, register for training here.

Questions? Call InstaMed at 877-834-8462 or CareSource Provider Services at 1-800-488-0134.

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 click on the EOP sample to see the format of CareSource's EOP.

Note to Providers Enrolling in EFT: By enrolling in EFT/ERA, you agree that you will NO LONGER receive a paper check or paper Explanation of Payment. These are available on the Provider Portal.

Pended claims

Providers also receive a separate report of pended claims twice a month via mail. Providers who choose EFT can receive their pended claims report through the Provider Portal.

Pended claims have not been denied. These are claims that have been entered into our system, but due to timing issues, have not yet been processed completely. We notify you of pended claims merely to acknowledge receipt.

Pending claims do not require action on your part; resubmission of pending claims may delay processing.