Quick Reference Materials

CareSource wants to equip you to work with our health plan to provide the best service for our members. The following materials will help familiarize you with the CareSource Ohio Medicaid plan. You will find key information that will make it easier for you to do business with us and assist you in serving our members.

Quick Reference Guides

Below you will find quick reference guides and additional resources:

• Navigate Next Generation Managed Care: Prior Authorization and Claims Quick Reference Guide
• Navigate Provider Attestation FAQs
• Navigate Provider Immunization Guide
• Provider Portal: Assessments and Care Treatment Plans Reference Guide
• Opioid Tool Kit
• Navigate Comprehensive Primary Care Reference Guide
• Navigate Clinical Practice Registry Guide
• Navigate Provider Portal Key Features Overview

Pregnancy & Child Resources

• PRAF 2.0, Efforts to Reduce Premature Births and Progesterone
• Progesterone Project
• Progesterone Messaging Toolkit
• Web-Based Pregnancy Risk Assessment Form – Providers are encouraged to complete and submit this form to assist pregnant women in maintaining Medicaid eligibility and connecting to needed services
• Navigate Preventing Preterm Birth: A Guide for Pregnant Women
• Navigate Completing a Well Visit during a Sick Visit

Improving Quality Scores

The following resources will help improve your patients’ satisfaction and your quality scores:

• Navigate 2022-2023 Adult HEDIS Coding Guide
• Navigate 2022-2023 Child and Adolescent HEDIS Coding Guide
• Navigate Patient Experience Guide (CAHPS resource guide)
• Navigate 2022-2023 Behavioral Health HEDIS Coding Guide
• Navigate 2022-2023 HEDIS Quality Companion Guide
• Navigate Access and Availability Standards

Clinical Practice Guidelines

CareSource adopts nationally recognized clinical practice and preventive health guidelines from federal agencies and medical professional specialty organizations. Access the links below and visit our Health Care Links page for more clinical practice and preventive health guidelines:

• ADHD Clinical Practice Guidelines
• Asthma Clinical Practice Guidelines
• Depression Clinical Practice Guidelines
• Navigate Diabetes Clinical Practice Guidelines
• Navigate Hypertension Clinical Practice Guidelines
• Maternal Programs and Prenatal/Postpartum Guidelines

Telehealth Toolkit

CareSource has developed resources to help you with your telehealth practice. Access the resources below for telehealth-related guidance.

• Navigate Telehealth HEDIS Measure Quick Reference Guide
• Navigate Telehealth Tip Sheet