Prior Authorizations & Referrals
Prior Authorization (PA) means that CareSource PASSE must review and approve the service before you receive it. Some covered services may need a prior authorization from CareSource PASSE before you can get them. Your provider will work with your care coordinator to arrange prior authorization. For a full list of services that require a prior authorization please view the prior authorization list or talk to your care coordinator.
Referral means that your provider will recommend or request that you get services or care from a specialist. Your provider will either call and arrange these services for you, give you a written approval to take with you to the referred services or specialist, or tell you what to do. Referrals are not always needed, but some specialists will ask for a referral before they will see you. Talk with your provider or care coordinator if you need any help.
- It is important to get care and services from providers and facilities in the CareSource PASSE network. Network or in-network provider refers to the providers who accept CareSource PASSE insurance and see our members. You do not need prior authorization for any office visit or procedure done at provider offices (PCP or specialists) in the CareSource PASSE network.
- When you see a provider who is not in the CareSource PASSE network, prior authorization is required except in emergency situations.
- Please check the prior authorization list on our website. This list can change throughout the year, so the website is usually the most up-to-date.
Member Services: 1-833-230-2005 (TDD/TTY: 711) Monday through Friday, 8 a.m. – 5 p.m. CT