Behavioral Health Carve-In

CareSource is here to support you during the transition to Behavioral Health Carve-In. Find valuable information on a variety of topics, including:

  • Updating your provider roster
  • Claims testing
  • Contracting
  • How to contact us with Carve In questions
  • Carve In Resources

Provider Roster

Reviewing your provider roster will help CareSource make updates.

Email your roster to ProviderMaintenance@caresource.com.

Your roster should contain:

  • Group information: Tax ID, Tax ID, Medicaid ID, Group NPI, Group Name, Mental Health or Substance Use Disorder, City, State, Zip
  • Practitioner information: Medicaid ID, NPI, Last Name, First Name, Type and Specialty
  • Inclusion of multiple or DBA (doing business as) names, if applicable
  • Additional location information

Once CareSource reviews your roster, we will email our findings to you.

Testing

Testing is a great way to ensure a smooth start to your onboarding with CareSource! We will continue to support requests for our behavioral health providers beyond the July the 1 go-live date.

Please complete the steps below to initiate testing with us:

  • Establish clearinghouse connections.
ClearinghousePhoneWebsite
Alveo800-327-1213www.alveohealth.com
Availity800-282-4548www.availity.com
Change Healthcare800-845-6592www.changehealthcare.com
Practice Insight832-476-9030www.practiceinsight.com
Quadax440-777-6305www.quadax.com
RelayHealth800-527-8133www.relayhealth.com
ZirMed877-494-7633www.zirmed.com

Once CareSource completes testing, we will email our findings to you.

Contracting

We are excited to partner with you. To start the contracting process, please complete the following.

You will need your CAQH ID number, Tax ID number, NPI number, name, specialty and W9 to complete the form.

Continuity of Care PeriodAll managed care plans have extended the Continuity of Care period to the end of 2018. All claims will be reimbursed at participating rates during this time frame. We encourage all providers to contract with CareSource to continue receiving participating provider rates beyond the Continuity of Care time period.

Support

CareSource is available to assist with your transition to managed care.

Contact Us

Call CareSource at 1-800-488-0134 if you have questions about our plan. We are available Monday to Friday, 7 a.m. to 7 p.m.

Exciting news: CareSource has dedicated behavioral health service representatives available to answer your questions about benefits, claims, member eligibility and more.

Talk to Us Live at Weekly Forums

CareSource hosts a weekly forum to answer your questions related to Behavioral Health Redesign.

Forums are held every Wednesday from 3 to 4 p.m.

Register: OhioBHInfo@caresource.com to request registration information. Please include your organization name, your agency NPI(s) and the names and email addresses of the individuals who will attend.

Resources

Provider Portal

Submit claims, check claims status, review member eligibility and view payment information.

Prior Authorization

Submit the universal NavigateOhio Association of Health Plans form to request prior authorization for outpatient behavioral health services.

NavigateOhio Urine Drug Screen Prior Authorization Form – Submit this form to request prior authorization for urine drug screening for Ohio Medicaid patients with a substance use disorder.

Benefit Grids

NavigateMyCare and Medicaid Outpatient Hospital Benefit Grid – Use this benefit grid to understand the hospital covered services for behavioral health services.

NavigateMyCare and Medicaid CBHC (Community BH Centers) Benefit Grid – Use this benefit grid to understand the community behavioral health center covered services for behavioral health services.

NavigateMyCare and Medicaid Opioid Treatment Programs (OTP) Benefit Grid– Use this benefit grid to understand the Ohio Department of Medicaid (ODM) and Mental Health and Addiction Services (Ohio MHAS) Opioid Treatment Program (OTP) Medicaid covered services for providers already enrolled as a provider type 95 (community substance use disorder program) with provider specialty 950 AND either licensed by OhioMHAS as a methadone treatment administration program (provider specialty 951) AND/OR certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) as an OTP (provider speciality 953) may request the addition of a provider specialty for methadone administration and/or buprenorphine based medication administration.

NavigateMyCare and Medicaid Group Medical Practices Benefit Grid – Use this benefit grid to understand the covered services for behavioral health services provided by Group Medical Practices.

NavigateMyCare and Medicaid Specialized Recovery Services (SRS) Benefit Grid – Use this benefit grid to understand the covered services for Specialized Recovery Services (SRS) Program [1915(i)]. The SRS program is available to individuals who meet certain financial criteria and have been diagnosed with a serious and persistent mental illness (SPMI). Individual eligibility and program enrollment criteria are detailed in Administrative Code rule 5160-43-02. In addition to full Medicaid coverage, individuals enrolled in the SRS program have access to these new services: Individualized Placement and Support-Supported Employment (IPS-SE) and Peer Recovery Support (PRS).

For general Behavioral Health Redesign questions, please visit the ODM/OhioMHAS Redesign website.