Marketplace Prior Authorization Submissions Notice

Attention Michigan Marketplace providers – authorization requests for Michigan Marketplace members must be submitted via the provider portal. Fax submissions will NOT be accepted.

Talk with Your Patients About Preventive RSV Treatments

Respiratory syncytial virus (RSV) season began November 1, 2024. Remember to discuss the available preventive treatments with your eligible patients. Prevention of severe RSV can decrease hospitalizations for our most vulnerable members.

Attention Providers

Use the CareSource Provider Portal to access:

• • Claim status and submission,
  • Eligibility and Benefits,
  • Post-service disputes and appeals,
  • Prior Authorization status and request submission,
  • Provider maintenance

Talk with Your Patients About Preventive RSV Treatments

Respiratory syncytial virus (RSV) season began November 1, 2024. Remember to discuss the available preventive treatments with your eligible patients. Prevention of severe RSV can decrease hospitalizations for our most vulnerable members.

Attention Providers: Member Lookup

Welcome Providers!

Here are some highlights and navigation tips for the Provider Portal.

From the top-right side, toggle between providers by selecting the drop-down and choosing the applicable provider’s name.

• Each account will display with the Tax ID and Provider Name.
• Click the account you want to switch to.
• Search for the Tax ID or Provider Name to locate the appropriate account.
• From the left-hand navigation you will have access to the functionalities listed below:
  • Member Search
  • Access member eligibility
  • Find out if the member has other health care insurance coverage
  • Upload documents related to members
  • View members currently assigned to providers.
  • Identify and prioritize needed health care services, screenings, and tests for members
  • Submit and check the status of any claim you have submitted with a date of service January 1, 2025 or later
  • View payment history
  • Submit a claim dispute or appeal Providers > Prior Authorizations
  • Submit prior authorization requests
  • Check status, make updates, and view with letters related to a prior authorization

For more details, click here to access the Provider Portal QuickStart Guide.

Feel Better in Just Six Weeks!

Your health is our number one priority. Are you or a loved one in your household living with a long-term health condition? You can get help staying healthy without leaving your home. We have teamed up with Better Choices, Better Health^® (BCBH). BCBH can help you manage your risk for chronic conditions. When you join BCBH, you’ll join a small group of people just like you managing pain, stress and increased isolation.

The 6-week online workshop is free to adults living in Michigan who have a chronic health condition or disability. The workshop is an ideal way to receive support and learn new ways to manage pain, medications or whatever matters most to you.

Contact BCBH at 1-800-482-1455 or visit their website to sign-up today!

Y0119_OH-DSNP-P-3419000_C Provider Expansion Website Banner – updates announcements

We’ve expanded our provider network by 50%!
Our statewide coverage helps members have consistent care and benefit coverage. Members can visit Find A Doctor/Provider to access our network.
Thank you for your partnership and help increasing member access to care!

Y0119_OH-DSNP-M-3392268_C Provider Expansion Website Banner – Plan Documents

We expanded our provider network by 50%!
Our statewide expanded network helps you have consistent care and benefit coverage with your providers.

Find A Doctor/Provider now!

Y0119_OH-DSNP-M-3392268_C Provider Expansion Website Banner – Medical Benefits

We expanded our provider network by 50%!
Our statewide expanded network helps you have consistent care and benefit coverage with your providers.

Find A Doctor/Provider now!

Y0119_OH-DSNP-M-3392268_C Provider Expansion Website Banner – Benefits Services

We expanded our provider network by 50%!
Our statewide expanded network helps you have consistent care and benefit coverage with your providers.

Find A Doctor/Provider now!

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