Quick Reference Materials
The following materials will help familiarize you with CareSource MyCare Ohio. You will find key information that will make it easier to do business with us and assist you in serving our members.
CareSource MyCare Ohio Resources
Behavioral Health Resources
The links below provide valuable information for behavioral health providers regarding CareSource MyCare Ohio:
- Common Reasons for Behavioral Health Provider Claim Rejections (coming soon) – a brief explanation of claims rejections provided by Practice Insight
Clinical Practice Guidelines
CareSource adopts evidence-based, nationally recognized clinical practice and preventive health guidelines from federal agencies, medical professional specialty organizations and chronic health organizations. Visit our Health Care Links page for more clinical practice and preventive health guidelines.
Improving Quality Scores
The following resources will help improve your patients’ satisfaction and your quality scores:
- 2025-2026 HEDIS Provider Reference Guide (coming soon)
- CPT II Coding Guide (coming soon)
- Patient Experience Guide (CAHPS Resource Guide) (coming soon)
Evolent Health
We work with Evolent Health for radiology and imaging services. Call 1-866-642-9701 (TDD/TTY: 1-866-753-9424) or visit www.RADMD.com for more information.
Pregnancy Resources
- Pregnancy Risk Assessment (coming soon)
- Completing a Well Visit During a Sick Visit (coming soon)
Quick Reference Guides
Below you will find quick reference guides and additional resources:
- Access and Availability Standards (coming soon)
- Clinical Practice Registry Guide
- Electronic Visit Verification FAQs (coming soon)
- Electronic Visit Verification Requirements (coming soon)
- Health Outcomes Survey Tip Sheet (coming soon)
- ODM Telehealth Billing Provider Reference Guide (coming soon)
- Opioid Tool Kit (coming soon)
- Provider Attestation FAQs (coming soon)
- Provider Immunization Quick Reference Guide (coming soon)
- Provider Portal Key Features Overview
LTSS and HCBS Resources
LTSS and HCBS are Medicaid programs for qualifying individuals with functional limitations who receive support with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). ADLs and IADLs include activities like bathing, using the bathroom, doing laundry and grocery shopping. These services can be provided in the member’s home or in a community setting such as an Assisted Living Facility depending on the member’s choice. CareSource wants to equip providers with resources to best serve qualifying members. See below to learn more about LTSS and HCBS programs.
- LTSS Contracting Guide
- PNM Resource Guide for Waiver Providers
- How to Submit a Corrected Claim
- Claim Submission for LTSS Providers
- LTSS/HCBS Provider Orientation
Billing Guidance
- MyCare Waiver Billing Guidelines – State Plan PDN
- MyCare Waiver Billing Guidelines – Home Care Attendant
- MyCare Waiver billing Guidelines – Independent (Non-Agency) Personal Care Aides
- MyCare Waiver billing Guidelines – Nursing
- General Billing Guidelines
Additional Resources
- Ohio Department of Medicaid MyCare-Ohio
- Ohio Benefits Long-Term Services and Supports
- Home- and Community-Based Services Settings | Medicaid
- Ohio Home and Community-Based Waiver Services Provider Network Development and Oversight
- Long Term Services & Supports | Medicaid
Topics of Interest
Access the following topics to quickly find additional information:
- Member Plan Documents
- Fair Hearing Plan (coming soon)