Provider Grievances

Providers may file grievances related to members, other providers or operational issues of the plan:

• You can file a grievance within 60 calendar days of the decision or event through the Provider Portal, in writing or by calling us:

Humana – CareSource
Attn: Provider Grievances
P.O. Box 1947
Dayton, OH 45401-1947

Phone: 1-844-607-2831

Fax: 1-844-417-6262

• Include documentation to support your complaint and the actions taken to resolve it.
• We will investigate the substance of all grievances, resolve and notify you and the member, if applicable, within 30 days of receiving the grievance. This period may be extended an additional 14 days.

Humana – CareSource will thoroughly investigate each provider complaint using applicable statutory, regulatory and contractual provisions, collecting all pertinent facts from all parties and applying the Humana – CareSource written policies and procedures. We ensure that Humana – CareSource executives with the authority to require corrective action are involved in the provider complaint process.