Claims
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 (along with any documentation), track claim payments and more. CareSource offers this service at no cost.
Submit Claims Online Using the Provider Portal
Benefits of Submitting Claims Online
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.
| Helpful Tools & Resources | |
|---|---|
|
Itemized Bill Cover Sheet Submit this cover sheet and itemized statement for high dollar claims. | Non-Participating Provider Profile Form Non-participating providers must submit claims using the Non-Participating Provider Profile Form. We are unable to process claims without this information. Please be sure to attach your W-9 form when you submit this online form. |
|
Overpayment Recovery Form Submit this form to offset overpaid claims against a future payment. |
Payment Review Use this tool to reference CareSource’s pre- and post-payment review processes and appropriate contacts. |
| Provider Manual Refer to the Provider Manual for detailed information to submit claims | |
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 Using the Provider Portal
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. Refer to the Provider Manual for instructions to submit paper claims.
Note: Providers are highly encouraged to upload paper claims via the Provider Portal.
Additional Information
For more information regarding the provider disputes and appeals, please visit the Disputes and Appeals page. If you have questions not addressed on our website, please contact the CareSource Claims department at 1-800-488-0134.