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.

CareSource accepts claims in a variety of formats, including online and paper claims.

Recommended Option: Submit Claims Online

Providers have the option to submit claims through our secure, online Provider Portal. You can submit claims, track claim payments and more. CareSource offers this service at no cost.

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 claims status
• Minimal staff training or cost

Refer to the Provider Manual for detailed information to submit claims.

CareSource also partners with Availity to offer electronic claim submission and real-time transactions at no charge through the Availity Portal. You can use the Availity Portal Registration Guide to get signed up.

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.

Coordination of Payment

CareSource makes coordinating of payments simple. The process is as follows:

1. The provider must submit claims to CareSource to pay for Medicare covered services.
2. Upon approval, CareSource will send back an Explanation of Payment (EOP) to the provider.
3. The provider may submit the EOP to the State to submit claims for Medicaid covered services and/or cost share.

Alternative Option: Submit Paper Claims

For the most efficient processing of your claims, CareSource recommends you submit all claims electronically. Paper claim forms are encouraged only for services that require clinical documentation or other forms to process. If providers choose this option, we advise you upload images of the paper claims via the Provider Portal.

Refer to the Provider Manual for instructions to submit paper claims.

Payment Review

NavigatePayment Review Tool – Use this tool to reference CareSource’s pre- and post-payment review processes and appropriate contacts.

Submit Claims Online via The Provider Portal