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. 

Preferred Option: Submit Claims Online

Providers have the option to submit claims through our secure, online provider portal. You can submit claims and any necessary attachments, track claim payments and more. CareSource offers this service at no cost.

Submit Claims Online Using the CareSource Provider Portal

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

Two types of claims may be submitted:

  • Professional medical office claims
  • Institutional claims

Provider Services Team

For further assistance, please contact our Provider Services team at 1-833-230-2112.

Helpful Tools & Resources

  • Availity Portal – CareSource also partners with Availity to offer electronic claim submission and real-time transactions at no charge. You can use the Availity Portal Registration Guideto get signed up.
  • Itemized Bill Cover Sheet (coming soon) – Submit this cover sheet and itemized statement for high dollar claims.
  • Non-Participating Provider Profile Form (coming soon) – Non-participating providers may submit claims to CareSource using this 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
  • Overpayment Recovery Form (coming soon) – Submit this form to offset overpaid claims against a future payment.
  • Payment Review Tool (coming soon) – Use this tool to reference CareSource’s pre- and post-payment review processes and appropriate contacts.
  • Provider Manual – Refer to the CareSource Provider Manual for detailed information on how to submit claims.
  • Waiver Services Claim Entry and Service Plan Training Presentation (coming soon) – Review instructions for submitting claims and/or appeals for denial of claims.

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.

Submit Claims Online via the provider portal

Alternative Option: Paper Claims

Paper claim forms are encouraged only for services that require clinical documentation or other forms to process. Refer to the Provider Manual for instructions to submit paper claims.

Providers can upload paper claims via the provider portal. You can also mail or fax paper claims to the following address:

CareSource
Attn: Claims Department
P.O. Box 36
Dayton, OH 45420-0036