Provider Disputes or Appeals

• Include the member’s name and the CareSource member ID number.
• Include the provider’s name and ID number.
• Include the code(s) and reason why the determination should be reconsidered.
• If you are submitting a timely filing appeal, send proof of the original receipt of the appeal by fax or electronic data interchange (EDI).
• If the appeal is for a clinical edit denial, include supporting documentation to justify reversing the determination.
• Submit written appeals to:

CareSource
Attn: CTP Health Partner Appeals
P.O. Box 2008
Dayton, OH 45401-2008
Fax: 937-531-2398