EDI Clearinghouses
Electronic claims submission
CareSource has invested in an Electronic Data Exchange (EDI) system to enhance our service to participating providers. Our EDI system complies with the Health Insurance Portability and Accountability Act (HIPAA) standards for electronic claims submission. We are committed to offering you the most flexible and efficient means possible of doing business with us.
HIPAA requires that CareSource and all other covered entities comply with EDI standards for health care as established by the Secretary of Health and Human Services. In support of HIPAA and its goal of administrative simplification, we encourage providers and health care professionals to submit claims electronically. Electronic claims submission can have significant, positive impact on the productivity and cash flow for your practice.
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Reduces paperwork and costs associated with printing and mailing paper claims.
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Reduces time for CareSource to receive a claim by eliminating mailing time.
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Reduces delays due to incorrect claim information by returning errors directly to you through the same electronic channel. These claims can be corrected and resubmitted electronically.
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Improves accuracy by decreasing the chance for transcription errors and missing/incorrect data.
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Tracks and monitors claims through claim status reports received electronically.
EDI Clearinghouses
To submit claims electronically, providers must work with an electronic claims clearinghouse. CareSource currently accepts electronic claims from Ohio providers through the clearinghouses listed below. Please contact the clearinghouse of your choice to begin electronic claims submission. Please provide the clearinghouse with the CareSource payer ID number: 31114.
If you have questions, please call Provider Services toll-free at 1-800-488-0134.