How and When to File an Appeal

What is an Appeal?

An appeal is when you ask us to review a decision that denied a benefit or service.

The Appeal Process

If you believe a decision we have made adversely affects your coverage or benefits, you have a right to file an appeal.

Your appeal must have:

  • The covered person’s name and ID number as shown on the ID card
  • The provider’s name
  • The date of the medical service
  • The reason you disagree with the coverage denial
  • Any documentation or other written information to support your request

Online: Fill out the Member Standardized Appeal Form and submit it online.

Mail: Mail the form or a letter to:

CareSource
Attn: Grievance and Appeals
P.O. Box 1947
Dayton, OH 45401-1947

Learn more about appeals in your member handbook.

Questions? Call Member Services at 1-800-488-0134 (TTY: 711). We are open Monday through Friday, 7 a.m. to 8 p.m.