Forms

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Update Your Information

Please submit any changes within your practice using the Provider Maintenance Form on the Provider Portal. Simply login to the Portal and select “Provider Maintenance” from the navigation bars on the left-hand side of the page. You can update CareSource with changes such as:

  • Adding or deleting a provider to a group
  • Changing an address or phone number
  • Adding new restrictions or capacity limitations

The information will be submitted electronically to CareSource and you will receive an email verifying your requested changes.

NOTE – To change your Tax ID number, or update your IRS name, you must make those changes through an amendment to your contract, not through maintenance. You can make those changes using the New Health Partner Contract Form.

Member-Related Forms

Pharmacy Prior Authorization

Medical Prior Authorization

Claims

Disputes and Appeals

Fraud, Waste and Abuse