Updates/Announcements

Updates/Announcements are published for CareSource providers to communicate updates to policies and procedures.

The links below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

2012

Date
Posted

Provider/Group Change Request Form Updated 02/03/12
Individual Claim Payment of $500,000 and Higher 01/31/12
Preferred Specialty Pharmacy Provider 01/24/12
Update on 5010 Clearinghouse Claims Transactions and Issues 01/20/12
CareSource Pharmacy Policy on Stolen Controlled Substances 01/19/12

2011

 

Tips for 5010 Success: Submit Legacy ID & Correct Remittance Address 12/30/11
ODJFS/CareSource Reimbursement Changes for 2012 12/22/11
Radiation Safety and Most Frequently Requested Advanced Imaging Procedures 12/13/11
New Provider Portal Updates 11/22/11
Pharmacy Transition Period Reminder 11/15/11
Revised CareSource Venipuncture Policy - Updated 10/28/11
Refraction Policy 10/28/11
Revised Clinical Supporting Documentation Policy  - Updated 10/28/11
Medically Unlikely Edit (MUE) Policy for code 88342 10/28/11
CareSource Trading Partners Submitting EDI 837 Claims 10/25/11
Providers Who Administer Synagis® (palivizumab) - Effective November 1, 2011 10/17/11
September 26 Check Write Delayed for Paper Checks / EOPs 10/07/11
New Benefit Limits Feature on the CareSource Provider Portal 09/30/11
Quick Reference Guide for Non-Participating Providers 09/26/11
Prescription Drug Coverage Changing for Members of Ohio Medicaid - Effective October 1, 2011 09/16/11
Elective Labor and Delivery Prior to 39 Weeks Gestation 09/08/11
Enhanced Dental Management Services 09/06/11
Electronic Funds Transfer – Now Available for All Ohio Providers 08/12/11
CareSource Plan for 5010 Transition - (Update) Effective January 1, 2012 07/26/11
Ohio Debarred Attestation 07/18/11
NDC Requirements for Physician Administered Drugs in an Office Setting - Effective August 2, 2011 07/15/11
Ohio Passes House Bill 93 on Prescription Drug Abuse 06/27/11
3-day Payment Window for Outpatient Svcs Treated as Inpatient Svcs - Effective April 1, 2011 06/24/11
Requesting a Contract and Updating Provider Information Changes 06/02/11
Trigger Point Injection Policy - Effective July 1, 2011 05/25/11
Facet Joint and/or Joint Nerve Injection Policy  - Effective July 1, 2011 05/25/11
Epidural Steroid and Selective Transforaminal Epidural Injections - Effective July 1, 2011 05/24/11
Reimbursable Services for Chiropractors 05/24/11
CareSource Medicaid DME and Modifier Policy - Effective July 1, 2011 05/23/11
ODJFS Supports Electronic Health Records Incentive 05/16/11
PA Changes to Select Specialty Medications and Pain Management Procedures - Update 05/16/11
Enhanced Find a Doctor online search tool 05/16/11
Revised Immunization and Administration Billing Policy - Update 05/13/11
Enhanced Disease Management Program 05/2011
Member Education Strategies on Smoking Cessation 04/2011
New PA Changes to Select Specialty Medications and Pain Management Procedures 04/2011
Clinical Supporting Documentation Policy 04/2011
Corneal Tissue Acquisition Reimbursement Policy 04/2011
New Improved Explanation of Payment Form 04/2011
CareSource Plan for 5010 Transition 04/2011
EHR Incentive Program 03/2011
Updated Panel Closure for Select Provider Types: Podiatrists, Chiropractors 03/2011
Therapy Billing - Revised 03/2011
Facility Inpatient Reimbursement – Now Based on Admit Date 03/2011
CareSource Changes Transportation Vendor for Members 02/2011
Advanced Imaging Services Need NIA Privileges 02/2011
Change to Flu Codes for Special Needs Plan (SNP) Members 01/2011
APN Medicare Pricing/CMS Methodology 01/2011
APN Medicaid Pricing/ODJFS Methodology 01/2011
Provider Survey – Going on Now! 01/2011
Modifier Definitions 01/2011
CAHPS Survey Results 01/2011
What Constitutes a Material Change to an Existing Contract 01/2011
 

2010

Direct Access for Case Management/member needs now 24/7 12/2010
Important Reminder on Montgomery County Care Program 12/2010
Amended Urine Drug Screenings 12/2010
CareSource Medical Claim Edit z60 – Not a Primary Diagnosis 12/2010
Claim Overpayment Recoupment Policy 12/2010
Bilateral Procedures for Facility and Professional Claim Submissions 12/2010
Multiple Surgery Procedures for Facility and Professional Claim Submissions 12/2010
Claim Reprocessing Policy due to Systemic Errors 12/2010
FDA Withdraws Propoxyphene (Darvocet) from the Market 12/2010
Statewide Coverage for Vision Labs 10/2010
Panel Closure for Select Provider Types 10/2010
Claim Overpayment Recoupment Policy 10/2010
Observation Billing Policy 10/2010
Podiatry Services Policy 10/2010
CareSource Code Editing 10/2010
Reprinted September 11, 2010 Explanation of Payment (EOPs) 09/2010
Timely Filing Revisions 08/2010
Appealing Sterilization Claims 08/2010
Prevnar 13 Reimbursement – Backdated from March 18, 2010 08/2010
Member Benefits Based on Calendar Year 07/2010
Behavioral Health Therapy Billing & Reimbursement Policy 07/2010
Professional Developmental Testing Services Billing & Reimbursement Policy 07/2010
Confidential Provider Information and Unsecured Emails 07/2010
Urine Drug Screenings Billing & Reimbursement Policy 07/2010
Unlisted Procedure Code Billing Policy for Outpatient Facility Claims 07/2010
Payment Policy for Evaluation & Management Services Provided During
Global Surgery Period 		07/2010
Blood Specimen Collection Reimbursement Policy 07/2010
L-code Changes for 2010 07/2010
Advanced Practice Nurses to be Contracted as Primary Care Providers 05/2010
Services Requiring Prior Authorization 02/2010
Top Claim Denials 02/2010
Provider Issue Resolution Process 02/2010
Corrected Claims 02/2010
Hemoglobin and HealthChek Screening Visits 02/2010
Refractive Service Codes 02/2010
Prior Authorization Waived for Skilled Home Visits 01/2010

2009

Urine drug screen 12/2009
Home Health Agency Pharmacy Benefit Changes 12/2009