Prior Authorization

Request prior authorization for health care services via the Provider Portal or by phone, fax or mail.

 

to obtain prior authorization for emergency admissions. Outpatient emergency services do not require prior authorization.

To request prior authorization for observation services as a nonparticipating provider or to request authorization for an inpatient admission, please call  and follow the appropriate menu prompts. During regular business hours, your call will be answered by our Medical Management department.

Please call  for any questions related to post-stabilization services.

Prior Approval

Services requiring prior approval include:

  • Prison in-reach in person that exceeds two events per year 
  • Prison in-reach via video conference that exceeds four events per year
  • Support for housing
  • Transportation that exceeds one event per month
  • Identification fund that exceeds two events per year

Submit requests for prior approval to CareSource at 1-844-539-1729.

Prior Authorization

Services requiring prior authorization include intensive outpatient services that exceed 30 days.

Submit requests for prior authorization to CareSource via:

Use the Prior Authorization Request Form to submit written prior authorization requests.

  • Fax: 1-937-487-1664
  • Mail:  CareSource, Attn: CTP Medical Services Department. PO Box 1307, Dayton, OH 45401-1307

Please note: Approvals and authorizations may be different for members with Medicaid coverage. Check with the individual’s medical plan to see if services require authorization. Some services may be covered under medical insurance. Check with the member’s health plan for the full scope of benefits.