Provider Manual

The CareSource Provider Manual contains information about our health care plans, policies and procedures, and general guidelines. The Manual provided below includes information for our Covered Families and Children (CFC) Medicaid, Aged, Blind or Disabled (ABD) Medicaid and Medicare Advantage Special Needs Plan (SNP) members.

Please click on the section links below to view or print the CareSource Provider Manual.

• Cover Page
• Table of Contents
• Introduction
• Key Contract Provisions
• Primary Care Providers
• Member Enrollment and Eligibility
• Member Support Services and Benefits
• Covered Services and Exclusions
• Referrals and Prior Authorizations
• Claims Submissions
• Appeals Procedures
• Quality Improvement Program
• Credentialing and Recredentialing
• Fraud, Waste and Abuse
• Pharmacy
• Forms and Materials

If you have any questions or would like more information, please call Provider Services at 1-800-488-0134 or contact your designated Provider Relations Representative.

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Please Note

CareSource has many materials available for providers. You will need Adobe Acrobat Reader to open these files. If you do not have the latest version of Adobe Acrobat Reader, you may download it here.