Past Updates & Announcements

We strive to make partnering with us simple. We’re aware things may change in the way we do business with you and want to communicate these changes to you in an efficient manner.

Visit the Updates & Announcements page frequently to find all the latest CareSource news. We share updates regarding:

Pharmacy information, including our Preferred Drug Lists (PDLs)
Medical, pharmacy, reimbursement and administrative policies
Authorization requirements as communicated through network notifications below

The links below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

2020	Date
Navigate Introducing New Prior Authorization Procedure Code Look-Up Tool	12/17/2020
Navigate Register With Dental Partner DentaQuest - Reminder	12/17/2020
Navigate Nursing Facility Assessment Tool	12/09/2020
Navigate 2021 Prior Authorization List Reminder	12/01/2020
Navigate Policy Updates December 2020	12/01/2020
Navigate Register with CareSource’s Payment Partner ECHO Health	11/23/2020
Navigate 2020-2021 Respiratory Syncytial Virus (RSV) Season and Synagis® Criteria	11/23/2020
Navigate CareSource Cultural Competency Training	11/17/2020
Navigate Policy Updates November 2020	11/01/2020
Navigate Home Health Value Code Requirement	10/26/2020
Navigate Updates to Marketplace Prior Authorization List	10/19/2020
Navigate DentaQuest to Administer Marketplace Exchange Dental Benefits	10/02/2020
Navigate Policy Updates October 2020	10/01/2020
Navigate Claim Payment Advice (835) Enhancements	09/23/2020
Navigate Enhanced Claim Editing Implementation	09/21/2020
Navigate Risk Adjustment Coding Education	09/08/2020
Navigate Claim Remittance Delay	09/03/2020
Navigate Enhanced Claim Editing Implementation	09/01/2020
Navigate Policy Updates September 2020	09/01/2020
Navigate 2020 Global Quality Enhancer Program	08/06/2020
Navigate Provider Directory Information Attestation	08/04/2020
Navigate Policy Updates August 2020	08/01/2020
Navigate Enhancements to Prior Authorizations on Provider Portal – UPDATE	07/27/2020
Navigate Durable Medical Equipment Billing Resource Tool	07/23/2020
Navigate Risk Adjustment Coding Education	07/15/2020
Navigate Policy Updates July 2020	07/01/2020
Navigate Interactive Voice Response (IVR) Enhancements for Providers	06/25/2020
Navigate Feedback Requested: SNF Provider Summit Ideas	06/22/2020
Navigate Provider Portal Claims Submittal Enhancement	06/15/2020
Navigate Policy Updates June 2020	06/01/2020
Navigate Holiday Claim Remittance Delays	05/19/2020
Navigate Risk Adjustment Education	05/14/2020
Navigate Policy Updates May 2020	05/01/2020
Navigate Provider Portal Claims Quick Start Guide – UPDATE	04/29/2020
Navigate Designation of Availity as Exclusive EDI Gateway	04/15/2020
Navigate Correct Payer ID for Claims Submissions	04/06/2020
Navigate Policy Updates April 2020	04/01/2020
Navigate Site of Care Policy Update	04/01/2020
Navigate Policy Updates February 2020 – UPDATE	04/01/2020
Navigate Recent Provider Portal Updates	03/30/2020
Navigate FQHC and RHC Provider Billing Reminder	03/27/2020
Navigate Issue Resolution: Electronic Remittance Advice (ERA) PLB and Claim Level Adjustments	03/13/2020
Navigate Provider Portal Quick Start Guide – This notification has been revised. See notification dated 04/29/2020.	03/11/2020
Navigate Consent Forms Reminder	03/05/2020
Navigate FQHC Use of Uniform Billing Form UB-04 – UPDATE	03/03/2020
Navigate Access and Availability Standards	03/02/2020
Navigate Policy Updates March 2020	03/01/2020
Navigate FQHC Use of Uniform Billing Form UB-04 – This notification has been revised. See notification dated 03/03/2020.	02/19/2020
Navigate Annual Notice of Requirements	02/19/2020
Navigate Provider Dispute Process – UPDATE	02/19/2020
Navigate Instructions on Attaching Medical Records in Provider Portal	02/07/2020
Navigate Policy Updates February 2020 – This notification has been revised. See notification dated 04/01/2020.	02/01/2020
Navigate Recent Provider Portal Updates	01/28/2020
Navigate Paper Checks Dated 1/21, 1/22, 1/23	01/27/2020
Navigate EAPG Claims Status	01/22/2020
Navigate Policy Updates January 2020 – UPDATE	01/20/2020
Navigate Provider Payment Migration Complete	01/13/2020
Navigate High Dollar Claims Cover Sheet – UPDATE	01/07/2020
Policy Updates January 2020 – This notification has been revised. See notification dated 01/20/2020.	01/01/2020

2019	Date
Navigate Updates to Marketplace Prior Authorization List	12/09/2019
Navigate Register with New Payment Partner ECHO Health by December 13 – Deadline Extended Again!	12/02/2019
Navigate Policy Updates December 2019	12/01/2019
Navigate Holiday Claim Remittance Delay	11/26/2019
Navigate ICD-10 Code Update	11/26/2019
Navigate Delay in Claim Payments	11/13/2019
Navigate Policy Updates November 2019	11/01/2019
Navigate Dual-Eligibility Billing Reminder	10/31/2019
Navigate Policy Updates October 2019	10/01/2019
Navigate Register with New Payment Partner ECHO Health by December 1 – This notification has been revised. See notification dated 12/02/2019	09/25/2019
Navigate Recent Provider Portal Updates – UPDATED 10/3	09/23/2019
Navigate Consent Form Upload Enhancement to the Provider Portal – UPDATE	09/05/2019
Navigate Enhancements to Prior Authorization on Provider Portal – This notification has been revised. See notification dated 07/27/2020.	09/05/2019
Navigate September 2019 Policy Updates	09/01/2019
Navigate Issue with Denials for Physical Therapy (PT) Units	08/23/2019
Navigate Issues with Outpatient Claim Denials Due to Authorizations Expiring	08/23/2019
Navigate 2019-2020 Ohio Provider Manual Now Available	08/06/2019
Navigate Facility Claim Cost Share	08/01/2019
Navigate Policy Updates August 2019	08/01/2019
Navigate Register with New Payment Partner ECHO Health by October 25 – This notification has been revised. See notification dated 09/25/2019	07/26/2019
Navigate Coordination of Benefits (COB) Reminder	07/22/2019
Navigate Duplicate Modifier on the Claim Service Line	07/17/2019
Navigate Post-Payment Audit Update	07/12/2019
Navigate Provider Dispute Process – This notification has been revised. See notification dated 02/19/2020.	07/05/2019
Navigate Policy Updates July 2019	07/01/2019
Navigate Multi-Factor Authentication Scheduled for SKYGEN CWP	06/21/2019
Navigate Prior Authorization Enhancements for Observation Stays	06/13/2019
Navigate Inpatient Hospital Pre-payment Claims Reviews - Revised 6/6/2019	06/03/2019
Navigate Updates to Marketplace Prior Authorization List	05/31/2019
Navigate Policy Updates June 2019	05/31/2019
Navigate Tips to Improve Pediatric CAHPS Ratings	05/29/2019
Navigate End-Stage Renal Disease (ESRD) Claims and Value Code D5	05/29/2019
Navigate Designating a Supervising Provider Using Paper Claims	05/17/2019
Navigate Upgrades to AHS Consent Form on the Provider Portal	05/13/2019
Navigate Access Standards Update	05/06/2019
Navigate Policy Updates May 2019	05/01/2019
Navigate Applied Behavior Analysis Rates and Pricing	04/04/2019
Navigate Update to Emergency Room Cost Share Application	04/01/2019
Navigate Policy Updates April 2019	04/01/2019
Navigate Enhancements to Delivery and Newborn Notifications – UPDATE	03/28/2019
Navigate Applied Behavioral Analysis (ABA) Billing and Coding	03/27/2019
Navigate Interventions to Prevent Perinatal Depression	03/13/2019
Navigate Provider Portal Survey	03/07/2019
Navigate Policy Updates May 2019	03/01/2019
Navigate High Dollar Claims – This notification has been revised. See notification dated 01/07/2020	02/19/2019
Navigate Behavioral Health Claim Issue Identified - UPDATE	02/19/2019
Navigate Place of Service Code for Claim Submissions	02/14/2019
Navigate Revenue Code 0636 Denials Update	02/13/2019
Navigate National Drug Code (NDC) with J1050 Denials Update	02/08/2019
Navigate Enhancements to Delivery and Newborn Notifications	02/01/2019
Navigate Hepatitis A Prevention	01/29/2019
Navigate Diagnosis Related Group (DRG) Validation Audits	01/21/2019
Navigate Dental Eligibility Update	01/11/2019

2018	Date
Navigate Policy Update March 2019	12/31/2018
Navigate Claim Denial Issue - Error Code X94	12/27/2018
Navigate Notice of Changes to Retro Prior Authorization Timeframe Requirements	12/26/2018
Navigate Behavioral Health Claim Issue Identified	12/19/2018
Navigate Issues with Claim Denying for National Drug Code (NDC)	12/14/2018
Navigate Remittance Delay for Wednesday, December 5, 2018 Payment Cycle	12/07/2018
Navigate Policy Updates January 2019	11/30/2018
Navigate Policy Updates January 2019	11/01/2018
Navigate Code Advisor Network Notification	10/23/2018
Navigate Duplicate Claim Processing Update	09/01/2018
Navigate Policy Updates November 2018	08/28/2018
Navigate Well-Child Care	08/27/2018
Navigate Consent to Share Sensitive Health Information	08/08/2018
Navigate Clarification of Indiana Network Closure Communication	07/30/2018
Navigate Increasing Claim Payment Processing Frequency – UPDATE	07/27/2018
Navigate Policy Updates October 2018	07/27/2018
Navigate Increasing Claim Payment Processing Frequency	07/03/2018
Navigate New Address for Refund Checks	07/03/2018
Navigate Policy Updates September 2018	06/29/2018
Navigate Notification of Claim Adjustments for Certain Edit Codes	06/13/2018
Navigate Policy Updates August 2018	06/12/2018
Navigate Breast Imaging Reimbursement Policy	06/05/2018
Navigate CareSource Secure Email Portal Security Enhancements	05/17/2018
Navigate Update to Provider Billing Address Requirements on Claims	04/03/2018
Navigate Policy Updates June 2018	03/30/2018
Navigate Update to Drug Testing Policy – UPDATE	03/12/2018
Navigate Policy Updates May 2018	02/28/2018
Navigate Diabetes Retinal Eye Exam	01/25/2018
Navigate New Approach to Educate and Reduce Evaluation and Management Billing Errors	01/08/2018

2017	Date
Navigate March 2018 Policy Release	12/28/2017
Navigate Update on Drug Testing Reimbursement Policy – UPDATE	12/01/2017
Navigate Notice of Change to Cardiac Services Prior Authorization Requirements	11/17/2017
Navigate December 2017 Policy Release	11/01/2017
Navigate November 2017 Policy Release	09/28/2017
Navigate Drug Screening Reimbursement Policy – This notification has been revised. See notification dated 12/01/2017.	08/30/2017
Navigate Announcing Enforcement of Enhanced Ambulatory Patient Groups Billing Guidelines – UPDATE	07/27/2017
Navigate September 2017 Policy Releases	07/27/2017
Navigate Update on Behavioral Health Denials for Code X50	07/26/2017
Navigate Blood Lead Testing Recommendations	07/05/2017
Navigate Retro Prior Authorizations	05/31/2017
Navigate PY-0108, PY-0109 Telemedicine-Telehealth Payment Policy	05/04/2017
Navigate Health Partner Manual Addition & Revisions - Access Standards	04/26/2017
Navigate PY-0037, PY-0205 Sexually Transmitted Infections Reimbursement Policy	04/19/2017
Navigate Screening and Surveillance for Colorectal Cancer	04/18/2017
Navigate MM-0034, MM-0079, MM-0080 Gender Dysphoria Medical Policy	04/14/2017
Navigate PY-0206 Hepatitis Panel Payment Policy	04/13/2017
Navigate Cite AutoAuth – Inpatient PA Requests	04/03/2017
Navigate PY-0226, PY-0227, PY-0228 Vitamin D Assay Testing Payment Policy	03/31/2017
Navigate PY-0222, PY-0223, PY-0224 Thyroid Testing Payment Policy	03/31/2017
Navigate PY-0181, PY-0185, PY-0187 Transthoracic Echocardiogram Payment Policy	03/31/2017
Navigate PY-0169, PY-0174, PY-0173 Sleep Studies Payment Policy	03/31/2017
Navigate PY-0163, PY-0167, PY-0168 Non-Invasive Vascular Studies Payment Policy	03/31/2017
Navigate PY-0089 - Drug Screening Payment Policy – This notification has been revised. See notification dated 08/30/2017.	03/20/2017
Navigate CareSource’s Marketplace Plans No Longer Called CareSource Just4Me	01/06/2017

2016	Date Posted
Navigate Cite AutoAuth Expansion for Inpatient Authorizations	08/23/2016
Navigate Updated EPSDT Claim Acceptance Criteria	07/28/2016
Navigate Suspension of EPSDT Claim Submission Criteria	07/22/2016
Navigate 10-Day Quantity Limit for Prescribing Opioids	07/11/2016
Navigate Notice of Medical Documentation Requirement for Claim Modifiers	06/14/2016
Navigate Spring 2016 Health Partner Education Forums	04/22/2016
Navigate Home Infusion Therapy Prior Authorization Requirements, Pharmacy Criteria and Billing Guidelines	03/25/2016
Navigate Curbing Opioid Overdose with Naloxone – UPDATE	03/14/2016
Navigate Paper Claims Processing: Rendering and Billing NPI Requirements	03/07/2016
Navigate Change in Behavioral Health Clinical Guidelines	01/20/2016

2015	Date Posted
Navigate ICD-10 Qualifiers	11/12/2015
Navigate Health Partner Network Notification	11/04/2015
Navigate Curbing Opioid Overdose with Naloxone – See notification dated 03/14/2016	11/03/2015
Navigate ICD-10 Coding Guidelines Available from CMS	09/16/2015
Navigate Getting Ready for ICD-10	09/09/2015
Navigate New Facility Code Edits for Claims	09/03/2015
Navigate CMS Posts ICD-10-CM and PCS Code Lists	08/13/2015
Navigate CMS and AMA Issue FAQs to Clarify ICD-10 Preparation Guidance	08/06/2015
Navigate Healthcare Clinic at Select Walgreens Now Accepting CareSource Members	07/28/2015
Navigate New Requirements for Corrected Claims Submissions Effective August 20, 2015	07/22/2015
Navigate CMS Creates Countdown Video, Infographic to Ease ICD-10 Transition	07/22/2015
Navigate Home Health and Hospice ICD-10 Coding Training Opportunity	07/15/2015
Navigate CMS and AMA Partner on ICD-10 Preparations	07/10/2015
Navigate CMS Case Studies Available to Explore ICD-10 Concepts	06/11/2015
Navigate CareSource Webinar, CMS Videos and Call Available for ICD-10 Prep	06/04/2015
Navigate Submit Claims Online Through Provider Portal	06/01/2015
Navigate ICD-10 Readiness Assessment	05/14/2015
Navigate Revised Clinical Supporting Documentation Policy	05/06/2015
Navigate Road to 10 Resource for ICD-10 Implementation	04/30/2015
Navigate Pediatric Clinical Guideline	04/15/2015
Navigate Cite Auto Auth	04/13/2015
Navigate ICD-10 Webinars Scheduled	04/13/2015
Navigate ICD-10 Transition Tips	03/30/2015
Navigate EDI Submission of Corrected Claims	02/16/2015
Navigate Electronic Submission of Coordination of Benefits (COB) Claims	02/12/2015
Navigate CareSource Dental Provider Updates	01/23/2015
Navigate Reminder to Check Member Eligibility for CareSource Just4Me™	01/22/2015

2014	Date Posted
Navigate CareSource Just4Me™ Resources Available on www.caresource.com	12/31/2014
Navigate UPDATE – ICD-10 Training Needs and Provider Checklist	11/07/2014
Navigate CareSource Just4Me Vision Benefit Update	07/03/2014
Navigate New Online Interactive Health Risk Assessment for OH Medicaid and CareSource Just4Me Members	07/01/2014
Navigate Reminder to Check Member Eligibility for CareSource Just4Me	03/03/2014
Navigate CareSource Just4Me Claims Submission	02/05/2014

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