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. 

Recommended Option: Submit Claims Online

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

Submit Claims Online Using the CareSource Provider Portal

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

CareSource’s traditional providers, community partners and delegates and health homes all may submit claims through the CareSource Provider Portal using online forms. Three types of claims may be submitted:

  • Professional medical office claims
  • Dental claims
  • Institutional claims
Helpful Tools & Resources

Provider Manual

Refer to the CareSource Provider Manual for detailed information on how to submit claims.

Availity Portal

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

CareSource Provider Portal Claim Submission User Guide

Access a detailed explanation of how to submit claims using online forms.

Waiver Services Claim Entry and Service Plan Training Presentation

Review instructions for submitting claims and/or appeals for denial of claims

Non-Participating Provider Profile Form

Non-participating providers may submit claims to CareSource using this 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.

Overpayment Recovery Form

Submit this form to offset overpaid claims against a future payment.

Payment Review Tool

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

Itemized Bill Cover Sheet

Submit this cover sheet and itemized statement for high dollar claims.

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.

Waiver Services Providers

MyCare waiver services providers can also submit claims through the Provider Portal, but they do not use the same process as traditional providers, community partners and delegates and health homes. All claims for waiver services reimbursement or appeals for claim denials should be submitted electronically through our Provider Portal.

If you are unable to log in to the Provider Portal and access your service plan, use the CMS 1500 Health Insurance Claim form to expedite your claim payment. You can access instructions to complete the form and a list of valid service codes.

You will use this paper claim process until you can log in to the Provider Portal and access your service plan. 

To ensure that we have the most up-to-date service plan for our MyCare Ohio members, please fax your service plan to 937-487-0936. This number is only for service plans and NOT claim submissions.

Alternative Method: 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.

You can also mail or fax paper claims to the following address:

Attn: Claims Department
P.O. Box 8730
Dayton, OH 45401-8730
Fax: 937-224-3388

More Information

For questions not addressed on our website, please contact the CareSource Claims department at 1-800-488-0134.