Laboratory

CareSource® covers laboratory testing services for our members. Laboratory service providers can access the following tools to help them provide efficient and quality care.

Policies

Providers can view CareSource’s laboratory policies and guidelines at Avalon Healthcare Solution’s web page. Laboratory services reported on claims will be reviewed for adherence and consistency with CareSource’s laboratory policies and guidelines, as well as industry standardized rules. The review will include evaluation of services for being experimental and/or investigative, as well as clinical appropriateness based upon patient demographic information.

Trial Claim Advice Tool

Providers may use the Trial Claim Advice tool to review claims with laboratory services for adherence and consistency with CareSource laboratory policies. This is a simulation tool and does not guarantee approval or reimbursement of claims. You can access the Trial Claim Advice Tool on the CareSource Provider Portal.

Updates & Announcements

Our goal is to keep you informed with timely information about our plan and services. As changes occur and as needs arise, we issue network notifications providers via the CareSource Updates & Announcements webpage.

Please check these pages often to learn about updates and changes that impact your practice.

Contact Us

If you have questions, please contact CareSource’s Provider Services at 1-800-488-0134. Our hours of operation are Monday through Friday, 8 a.m. to 6 p.m. Eastern Standard Time.