Forms

We want you to easily find the forms and documents you need for your CareSource PASSE plan. Explanations of when and why you may need to use a form or document are also provided below.

• Tell Us: Use this form when you would like to send us a question or request online.
• Member Consent/HIPAA Authorization Form: Grants permission for CareSource PASSE to speak with a caregiver, guardian or provider about a member’s medical, payment or protected health information.
• NavigateFraud, Waste and Abuse Reporting Form: If you suspect that a member, provider, or pharmacy is participating in fraud, waste, abuse or overpayment, please let us know.
• NavigateGrievances and Appeals Form: Use this form when you have a complaint about service you have received or would like to dispute a decision that has been made.