Claims

In addition to information about how to submit claims and check payments, CareSource® offers you tools to find specific information, such as claim status and member coordination of benefits (COB) status. 

CareSource accepts claims in a variety of formats, including online and paper claims.

Submit Claims Online

Providers have the option to submit claims through our secure, online Provider Portal. You can submit claims, track claim payments and more. CareSource offers this service at no cost.

We encourage you to submit claims online to take advantage of the following benefits:

  • Faster claim processing
  • Reduced administrative costs
  • Reduced probability of errors or missing information
  • Faster feedback on claims status
  • Minimal staff training or cost

Refer to the provider manual for detailed information to submit claims.

CareSource also partners with Availity to offer electronic claim submission and real-time transactions at no charge through the Availity Portal. You can use the Availity Portal Registration Guide to get signed up.

Get Paid Electronically

Simple – Receive fully reconciled remittances electronically; eliminate paper checks and Explanation of Payments (EOPs), which will increase efficiency with payment processing.

Convenient – Available 24/7; works in conjunction with electronic medical record (EMR) systems.

Free – EFT training is also available to CareSource providers through InstaMed during the enrollment process.

Reliable – Claim payments are electronically deposited into your bank account.

Providers have the option to submit claims through our secure, online Provider Portal. You can submit claims, track claim payments and more. CareSource offers this service at no cost.

Simply complete the Navigateenrollment form and fax it back to InstaMed, CareSource’s EFT partner, who will work directly with you to enroll in EFT. You can also enroll online.

Questions? Call InstaMed at 1-866-945-7990 or CareSource Provider Services at 1-855-202-1058.

Paper Claims

For the most efficient processing of your claims, CareSource recommends you submit all claims electronically. Paper claim forms are encouraged only for services that require clinical documentation or other forms to process.

Please send all paper claim forms to CareSource at the following address:

CareSource
Attn: Claims Department
P.O. Box 803
Dayton, OH 45401

Refer to the provider manual for instructions to submit paper claims.

Nonparticipating Providers

Nonparticipating providers may submit claims to CareSource using the Non-Participating Provider Profile Form. CareSource is unable to process claims without this information. Please be sure to attach your W-9 form when you submit this online form.

Claim Overpayment Recovery Requests and Resources

NavigateOverpayment Recovery Form – Submit this form to offset overpaid claims against a future payment.