How and When to File an Appeal
What is an Appeal?
An appeal is not the same as a complaint or grievance. If you do not agree with a decision or action made by CareSource in regard to your medical care, you have the right to appeal. An appeal is a request to reconsider and change the decision made or the action taken.
You have the right to appeal when:
- CareSource denies a service.
- CareSource gives partial approval to cover a service.
- CareSource denies payment of a service.
To learn more about appeals and how to file an appeal for your plan, choose your plan from the drop down list above, then click GO.