Claims

We want to make it as easy as possible to conduct business with us. 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.

Preferred Option: 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 claim 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.

Get Paid Electronically

CareSource has partnered with ECHO Health, Inc. to deliver provider payments. ECHO offers three payment options:

  1. Electronic Fund Transfer (EFT) – preferred
  2. Virtual Card Payment (QuicRemit) – Standard bank and card issuer fees apply*
  3. Paper Checks

*Payment processing fees are what you pay your bank and credit card processor for use of payment via credit card.

Enrollment Instructions

Enroll with ECHO for payment and choose EFT as your payment preference for CareSource.

Questions? Call ECHO Customer Support at 1-888-834-3511.

Alternative Option: Submit Paper Claims

For the most efficient processing of your claims, CareSource recommends you submit all claims electronically. Paper claims can also be uploaded via the CareSource Provider Portal. Refer to the Provider Manual for instructions to submit paper claims.

Non-Participating Providers

Non-participating 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

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

Providers may also submit overpayment recovery requests via the Provider Portal and receive a reference number.

High-Dollar Claims

Submit this Navigate Itemized Bill Cover Sheet and itemized statement for high dollar claims.