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 Medicare Advantage plans. 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 Provider Quick Reference Guide
• Opioid Tool Kit
• Navigate Immunization Quick Reference Guide
• Navigate Clinical Practice Registry Guide
• Navigate Health Outcomes Survey Tip Sheet
• Navigate Provider Portal Key Features Overview

Improving Quality Scores

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

• Navigate Patient Experience Guide (CAHPS resource guide)
• Navigate Adult HEDIS Coding Guide
• Navigate Child HEDIS Coding Guide
• Navigate Behavioral Health HEDIS Coding Guide
• Navigate HEDIS Quality Companion Guide

Clinical Practice Guidelines

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

• ADHD 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

Topics of Interest

• Member Plan Documents
• Fair Hearing Plan
• Nonparticipating Provider Appeals and Disputes

NIA Magellan Imaging Services

CareSource works with NIA Magellan Imaging Services for radiology and imaging services. Prior authorization is required for CT/CTA scans, MRI/MRA scans and PET scans.

Prior authorization may be requested online at http://www.RadMD.com or by calling 1-800-424-1741.

Please use the following resources to learn more, including how to obtain prior authorization for these services:

• Ordering Provider Quick Reference Guide
• Rendering Provider Quick Reference Guide
• Frequently Asked Questions
• Utilization Review Matrix