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.
Preferred 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 claim 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.
Get Paid Electronically
CareSource has partnered with ECHO Health, Inc. to deliver provider payments. ECHO offers three payment options:
- Electronic fund transfer (EFT) – preferred
- Virtual Card Payment (QuicRemit) – Standard bank and card issuer fees apply*
- 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.
Submit Claims Online Via the Provider Portal
Alternative Option: Paper Claims
For the most efficient processing of your claims, CareSource recommends you submit all claims electronically. Paper claims may be uploaded directly to the Provider Portal for processing. Refer to the Provider Manual for instructions to submit paper claims.
Non-Participating Providers
Non-participating providers may submit claims to CareSource using the Non-Participating Provider Profile Form. CareSource is unable to process claims without this information. Please be sure to attach your W-9 form when you submit this online form.
Claim Overpayment Recovery Requests and Resources
Overpayment Recovery Form – Submit this form to offset overpaid claims against a future payment.
Payment Review
Payment Review Tool – Use this tool to reference CareSource’s pre- and post-payment review processes and appropriate contacts.
High-Dollar Claims
Submit this Itemized Bill Cover Sheet and itemized statement for high dollar claims.