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.

NavigateUPDATE - Prior Authorization Requirements12/31/2020
NavigateTransplant Services Reimbursement12/30/2020
NavigateIntroducing New Prior Authorization Procedure Code Look-Up Tool12/17/2020
NavigateSolarWinds Cyberattack12/16/2020
NavigateCotiviti Payment Enhancement Notification12/15/2020
NavigateAnnouncing Innovative Partnerships for Pediatric Care12/09/2020
NavigateNursing Facility Assessment Tool12/09/2020
NavigateMandatory Medicaid Number Requirement12/04/2020
Navigate2021 Prior Authorization List Reminder12/01/2020
NavigatePolicy Updates December 202012/01/2020
NavigateDefinitive Urine Drug Testing Billing Update11/30/2020
NavigateEnhanced Services11/20/2020
NavigateACT/IHBT Disenrollment Expectations11/17/2020
NavigateCareSource Cultural Competency Training11/17/2020
Navigate2020-2021 Respiratory Syncytial Virus (RSV) Season and Synagis® Criteria11/04/2020
NavigatePolicy Updates November 202011/01/2020
NavigateQuarter 3 Provider Portal Updates10/28/2020
NavigateRetrospective Eligibility Timeframe Change10/28/2020
Navigate2020 Quarter 2 Provider Portal Updates10/05/2020
NavigatePolicy Updates October 202010/01/2020
NavigateClaim Payment Advice (835) Enhancements09/23/2020
NavigateEmergency BH Hospitalization Initial Medical Necessity Reviews09/22/2020
NavigateHome Health Value Code Requirement09/16/2020
NavigateDentaQuest Transition of Care Reminder09/10/2020
NavigateClaim Remittance Delay09/03/2020
NavigateEnhanced Claim Editing Implementation09/01/2020
NavigatePolicy Updates September 202009/01/2020
NavigateTransition of Care Update08/17/2020
NavigatePolicy Updates August 202008/01/2020
Navigate2020 Global Quality Enhancer Program07/31/2020
NavigateEnhancements to Prior Authorizations on Provider PortalUPDATE07/27/2020
NavigateOpioid Treatment Program Nasal Narcan Billing Guidance07/24/2020
NavigateDurable Medical Equipment Billing Resource Tool07/23/2020
NavigateProvider Directory Information Attestation07/22/2020
NavigateUpdates to Ohio Medicaid Prior Authorization List07/17/2020
NavigateRisk Adjustment Coding Education07/15/2020
NavigateCBHC Maximum Units Claim Denials07/13/2020
NavigatePolicy Updates July 202007/01/2020
NavigateInteractive Voice Response (IVR) Enhancements for Providers06/25/2020
NavigateFeedback Requested: SNF Provider Summit Ideas06/22/2020
NavigateProvider Portal Claims Submittal Enhancement06/15/2020
NavigatePolicy Updates June 202006/01/2020
NavigateHoliday Claim Remittance Delays05/19/2020
NavigateDME Code EditsUPDATE05/15/2020
NavigateRisk Adjustment Education05/14/2020
NavigateMedical Optometry Claims Processing05/06/2020
NavigatePolicy Updates May 202005/01/2020
NavigateNotice of DentaQuest Dental Plan Administration Date ChangeUPDATE04/30/2020
NavigateProvider Portal Claims Quick Start GuideUPDATE04/29/2020
NavigateCompleting a Well Visit During a Sick Visit04/20/2020
NavigateSubstance Use Disorder Residential Claim DenialsUPDATE04/20/2020
NavigateDesignation of Availity as Exclusive EDI Gateway04/15/2020
NavigateSubstance Use Disorder Residential Claim DenialsThis notification has been revised. See notification dated 04/20/2020.04/13/2020
NavigateCorrect Payer ID for Claims Submissions04/06/2020
NavigateSocial Determinants of Health Simulation Training04/03/2020
NavigateNotice of DentaQuest Dental Plan Administration Implementation Date ChangeThis notification has been revised. See notification dated 04/30/2020.04/01/2020
NavigatePolicy Updates April 202004/01/2020
NavigateSite of Care Policy Update04/01/2020
NavigatePolicy Updates February 2020UPDATE04/01/2020
NavigateRecent Provider Portal Updates03/30/2020
NavigateFQHC and RHC Provider Billing Reminder03/27/2020
NavigateTherapy Provider Credentialing Change03/24/2020
NavigateTransition of Care Extended for Superior Vision03/18/2020
NavigateIssue Resolution: Electronic Remittance Advice (ERA) PLB and Claim Level Adjustments03/13/2020  
NavigateProvider Portal Quick Start GuideThis notification has been revised. See notification dated 04/29/2020.03/11/2020
NavigateConsent Forms Reminder03/05/2020
NavigateAccess and Availability Standards03/02/2020
NavigatePolicy Updates March 202003/01/2020
NavigateNotice of DentaQuest Dental Plan Administration Implementation Date ChangeThis notification has been revised. See notification dated 04/30/2020.02/20/2020
NavigateAnnual Notice of Requirements02/19/2020
NavigatePrenatal Risk Assessment Forms02/18/2020
NavigateElectronic Visit Verification Correction02/18/2020
NavigateBehavioral Health Revenue Code Guidelines02/13/2020
NavigateProvider Transition Fill Correction02/10/2020
NavigateInstructions on Attaching Medical Records in Provider Portal02/07/2020
NavigateAvastin Claims Denied Incorrectly02/07/2020
NavigatePolicy Updates February 2020This notification has been revised. See notification dated 04/01/2020.02/01/2020
NavigateNotice of DentaQuest Dental Plan Administration  – This notification has been revised. See notification dated 04/30/2020.01/31/2020
NavigateAdditional Policy Updates January 202001/28/2020
NavigateRecent Provider Portal Updates01/28/2020
NavigatePaper Checks Dated 1/21, 1/22, 1/2301/27/2020
NavigateEAPG Claims Status01/22/2020
NavigatePayment for Laboratory Services Furnished by FQHCs or RHCs01/21/2020
NavigatePolicy Updates January 2020UPDATE01/20/2020
NavigateRegister with Superior Vision01/16/2020
NavigateAdditional Policy Updates January 202001/16/2020
NavigateDental Providers May Disregard ECHO Health Registration Notification01/14/2020
NavigateProvider Payment Migration Complete01/13/2020
NavigateDental Claims01/07/2020
NavigateHigh Dollar Claims Cover SheetUPDATE01/07/2020
Policy Updates January 2020 – This notification has been revised. See notification dated 01/20/2020.01/01/2020
NavigateGuidelines for Properly Reporting Billing Provider Address12/26/2019
NavigatePharmacy Network Change (Walgreens)12/11/2019
NavigateClaim Coding EditsThis notification has been revised. See notification dated 05/15/2020.12/04/2019
NavigateRegister with New Payment Partner ECHO Health by December 13Deadline Extended Again!12/02/2019
NavigatePolicy Updates December 201912/01/2019
NavigateHoliday Claim Remittance Delay11/26/2019
NavigateICD-10 Code Update11/26/2019
NavigateNew Primary Care Provider (PCP) Change Request Form11/14/2019
NavigateDelay in Claim Payments11/13/2019
NavigateImportant Provider Billing Address Reminder11/05/2019
NavigatePolicy Updates November 201911/01/2019
NavigateOhio Medicaid Unified PDL Announcement11/01/2019
NavigateDual-Eligibility Billing Reminder10/31/2019
NavigatePolicy Updates October 201910/01/2019
NavigateRegister with New Payment Partner ECHO Health by December 1This notification has been revised. See notification dated 12/02/201909/25/2019
NavigateRecent Provider Portal Updates – UPDATED 10/309/23/2019
NavigateNational Provider Identifier for Ordering, Referring, and Prescribing Providers09/10/2019
NavigateImportant Inpatient Covered Days Billing Reminder09/10/2019
NavigateConsent Form Upload Enhancement to the Provider PortalUPDATE09/05/2019
NavigateEnhancements to Prior Authorization on Provider PortalThis notification has been revised. See notification dated 07/27/2020.09/05/2019
NavigateSeptember 2019 Policy Updates09/01/2019
NavigateSUD Partial Hospital Program (PHP)08/27/2019
NavigateDurable Medical Equipment (DME) Recoveries08/26/2019
NavigateWound Vac (A7000) Requiring Authorization in Error08/23/2019
NavigateIssue with Denials for Physical Therapy (PT) Units08/23/2019
NavigateIssues with Outpatient Claim Denials Due to Authorizations Expiring08/23/2019
NavigateProvider Dispute ProcessUPDATE08/16/2019
NavigatePolicy Update August 201908/15/2019
NavigateCommunity Behavioral Health Claim Issue Trends and Guidance08/14/2019
NavigateElectronic Visit Verification Update08/09/2019
NavigateSUD Residential Treatment Policy Update08/09/2019
Navigate2019-2020 Ohio Provider Manual Now Available08/06/2019
NavigatePolicy Updates August 201908/01/2019
NavigateRegister with New Payment Partner ECHO Health by October 25This notification has been revised. See notification dated 09/25/201907/26/2019
NavigateReminder – Authorization Requirements for Ancillary Providers07/22/2019
NavigateCoordination of Benefits (COB) Reminder07/22/2019
NavigateDuplicate Modifier on the Claim Service Line07/17/2019
NavigatePost-Payment Audit Update07/12/2019
NavigateProvider Dispute Process – This notification has been revised. See notification dated 08/16/201907/05/2019
NavigatePolicy Updates July 201907/01/2019
NavigateMulti-Factor Authentication Scheduled for SKYGEN CWP06/21/2019
NavigatePolicy Updates June 201906/17/2019
NavigateDental Code D9230 Payment Policy Update06/14/2019
NavigateDental Sedation Codes Payment Policy Reminder06/14/2019
NavigateNon-Covered Dental Service Code Payment Policy Reminder06/14/2019
NavigatePrior Authorization Enhancements for Observation Stays06/13/2019
Navigate2019 Dental Procedure Code Updates06/10/2019
NavigateElectronic Visit Verification Training Update06/10/2019
NavigateInpatient Hospital Pre-payment Claims Reviews - Revised 6/6/201906/03/2019
NavigatePolicy Updates June 201905/31/2019
NavigateTips to Improve Pediatric CAHPS Ratings05/29/2019
NavigateEnd-Stage Renal Disease (ESRD) Claims and Value Code D505/29/2019
NavigateCommunity Behavioral Health Claim Issue Trends and Guidance05/28/2019
NavigateDesignating a Supervising Provider Using Paper Claims05/17/2019
NavigateUpgrades to AHS Consent Form on the Provider Portal05/13/2019
NavigateHigh Cost Radiology Services/NIA Authorization Denial for Hospitals 05/06/2019
NavigateElectronic Visit Verification Training Update05/06/2019
NavigateAccess Standards Update05/06/2019
NavigatePolicy Updates May 201905/01/2019
NavigateNew Policy Updates  April 201904/12/2019
NavigateStatewide Hepatitis A Outbreak Information04/12/2019
NavigateApplied Behavior Analysis Rates and Pricing04/04/2019
NavigatePolicy Updates April 201904/01/2019
NavigateEnhancements to Delivery and Newborn Notifications – UPDATE03/28/2019
NavigateApplied Behavioral Analysis (ABA) Billing and Coding03/27/2019
NavigateInterventions to Prevent Perinatal Depression03/13/2019
NavigateElectronic Visit Verification Training Update03/12/2019
NavigateProvider Portal Survey03/07/2019
NavigatePolicy Updates May 201903/01/2019
NavigateHigh Dollar Claims – This notification has been revised. See notification dated 01/07/202002/19/2019
NavigateBehavioral Health Claim Issue Identified - UPDATE02/19/2019
NavigatePlace of Service Code for Claim Submissions02/14/2019
NavigateRevenue Code 0636 Denials Update02/13/2019
NavigateNational Drug Code (NDC) with J1050 Denials Update02/08/2019
NavigateEnhancements to Delivery and Newborn Notifications 02/01/2019
NavigateHepatitis A Prevention01/29/2019
NavigateDiagnosis Related Group (DRG) Validation Audits01/21/2019
NavigateRequest Interpreter Services Online01/21/2019
NavigateIssues with Mammogram Benefit Limits01/14/2019
NavigatePolicy Update March 201912/31/2018
NavigateClaim Denial Issue - Error Code X9412/27/2018
NavigateNotice of Changes to Retro Prior Authorization Timeframe Requirements12/26/2018
NavigateBehavioral Health Claim Issue Identified12/18/2018
NavigateIssues with Claim Denying for National Drug Code (NDC)12/14/2018
NavigateRemittance Delay for Wednesday, December 5, 2018 Payment Cycle12/07/2018
NavigatePolicy Updates January 201911/30/2018
NavigateElectronic Visit Verification Reminder11/14/2018
NavigatePolicy Updates January 201911/01/2018
NavigateUpdated Prior Authorization Requirements for Home Care Services11/01/2018
NavigateCode Advisor Network Notification10/23/2018
NavigateElectronic Provider Appeals Required10/02/2018
 NavigatePolicy Updates December 201810/01/2018
NavigateAmbulance Overpayments and Incorrect Payments Recovery09/27/2018
NavigateQ3 2018 Payment Update09/27/2018
NavigateDME Overpayments and Incorrect Payments Recovery Notice09/27/2018
NavigateHome Health Overpayments and Incorrect Payments Recovery Notice09/27/2018
NavigatePhysician Assistant Overpayments and Incorrect Payments Recovery Notice09/27/2018
NavigateDuplicate Claim Processing Update09/01/2018
NavigateClarification on CareSource Medicaid Vision Benefit – UPDATE08/30/2018
NavigatePolicy Updates November 201808/28/2018
NavigateWell-Child Care08/27/2018
NavigateODM Medicaid Number Requirement08/27/2018
NavigateSignatures No Longer Needed for Medicaid Addendum Attachments for Provider Maintenance Updates08/21/2018
NavigateConsent to Share Sensitive Health Information08/08/2018
NavigateArchive Global Obstetrical Services Policy08/01/2018
NavigateClarification of Indiana Network Closure Communication07/30/2018
NavigateIncreasing Claim Payment Processing Frequency – UPDATE07/27/2018
NavigatePolicy Updates October 201807/27/2018
NavigateAdditional Update on CareSource Medicaid Vision Benefit – This notification has been revised. See notification dated 08/30/2018.07/24/2018
NavigateTrading Partners Administrative Policy07/20/2018
NavigateInventory Reduction Progress and Issue Reporting07/10/2018
NavigateIncreasing Claim Payment Processing Frequency07/03/2018
NavigateNew Address for Refund Checks07/03/2018
NavigatePolicy Updates September 201806/29/2018
NavigateNew Requirement to Report Individual NPIs in Rendering Fields of AHCC, FQHC, FBC, OHF and RHC Claims06/19/2018
NavigateNotification of Claim Adjustments for Certain Edit Codes06/13/2018
NavigatePolicy Updates August 201806/12/2018
NavigateDurable Medical Equipment (DME) Update06/08/2018
NavigateBreast Imaging Reimbursement Policy06/05/2018
NavigateTips to Prevent Payment Delays06/01/2018
NavigateCommunity Behavioral Health Centers (CBHC) Provider Orientation05/31/2018
NavigateCareSource Secure Email Portal Security Enhancements05/17/2018
NavigatePolicy Updates July 201804/19/2018
NavigateUpdate on CareSource Medicaid Vision Benefit – This notification has been revised. See notification dated 07/24/2018.04/18/2018
NavigateCare Coordination Codes Reminder04/16/2018
NavigateUpdate to Provider Billing Address Requirements on Claims04/03/2018
NavigatePolicy Updates June 201803/30/2018
Navigate2018 Dental Procedure Code Updates – UPDATE 03/28/2018
NavigateUpdate to Drug Testing PolicyUPDATE03/12/2018
NavigatePolicy Updates May 201802/28/2018
NavigatePY-0436 Sexually Transmitted Infections02/27/2018
Navigate2018 Dental Procedure Code UpdatesThis notification has been revised. See notification dated 03/28/2018.02/01/2018
NavigateCareSource No Longer Accepting 77057 Claim Code for Mammography Services01/26/2018
NavigateDiabetes Retinal Eye Exam01/25/2018
NavigateReminder to Include Gestational Age on Delivery Claims01/24/2018
NavigateNew Approach to Educate and Reduce Evaluation and Management Billing Errors01/08/2018
NavigateMarch 2018 Policy Release12/28/2017
NavigateCareSource Medicaid Vision Benefit – This notification has been revised. See notification dated 04/18/201812/11/2017
NavigateUpdate on Drug Testing Reimbursement Policy – UPDATE12/01/2017
NavigateNotice of Change to Cardiac Services Prior Authorization Requirements11/17/2017
NavigateUpcoming Deadline for Submitting Ohio Medicaid Provider Number Applications11/17/2017
NavigateEnhanced Ambulatory Patient Groups (EAPG) Billing Methodology Supersedes CareSource Payment Policies11/07/2017
NavigateDecember 2017 Policy Release11/01/2017
NavigateDiagnosis Related Group Rate Changes10/24/2017
NavigateUpdate Regarding Enhanced Ambulatory Patient Group (EAPG) Billing Payment Methodology10/10/2017
NavigateNovember 2017 Policy Release09/28/2017
NavigatePY-0101 - Genetic Testing- Polymerase Chain Reaction09/22/2017
NavigateClinical Appeals Require Member Consent09/22/2017
NavigateUpdate on Processing Claims for Enhanced Ambulatory Patient Groups – UPDATE09/01/2017
NavigateDrug Screening Reimbursement Policy – This notification has been revised. See notification dated 12/01/2017.08/30/2017
NavigateUpdate on Claim Configurations for Genetic Testing - Polymerase Chain Reaction – UPDATE08/17/2017
NavigateUpdate on Claim Configurations for Genetic Testing - Polymerase Chain Reaction – This notification has been revised. See notification dated 08/17/2017.08/14/2017
NavigatePY-0020 - Drug Screening Payment Policy – This notification has been revised. See notification dated 08/30/2017. 07/31/2017
NavigateAnnouncing Enforcement of Enhanced Ambulatory Patient Groups Billing Guidelines – This notification has been revised. See notification dated 09/01/2017.07/27/2017
NavigateSeptember 2017 Policy Release07/27/2017
NavigateUpdate on Behavioral Health Denials for Code X5007/26/2017
NavigateBehavioral Health Respite Care Services for Children07/18/2017
NavigateBlood Lead Testing Recommendations07/05/2017
NavigateUpdate on Configurations for Sexually Transmitted Infections Claims06/23/2017
NavigateJuly 2017 Policy Releases05/31/2017
NavigateRetro Prior Authorizations05/31/2017
NavigatePY-0037, PY-0205 Sexually Transmitted Infections Reimbursement Policy04/19/2017
NavigateScreening and Surveillance for Colorectal Cancer04/18/2017
NavigateMM-0034, MM-0079, MM-0080 Gender Dysphoria Medical Policy04/14/2017
NavigatePY-0206 Hepatitis Panel Payment Policy04/13/2017
NavigateUpdate on Claim Configurations for Specialty Codes and Durable Medical Equipment04/13/2017
NavigatePY-0128 Three-Day Window Payment Policy04/10/2017
NavigateCite AutoAuth – Inpatient PA Requests04/03/2017
NavigatePY-0226, PY-0227, PY-0228 Vitamin D Assay Testing Payment Policy03/31/2017
NavigatePY-0222, PY-0223, PY-0224 Thyroid Testing Payment Policy03/31/2017
NavigatePY-0181, PY-0185, PY-0187 Transthoracic Echocardiogram Payment Policy03/31/2017
NavigatePY-0169, PY-0174, PY-0173 Sleep Studies Payment Policy03/31/2017
NavigatePY-0163, PY-0167, PY-0168 Non-Invasive Vascular Studies Payment Policy03/31/2017
NavigatePY-0157 Glycosylated Hemoglobin A1C Payment Policy03/29/2017
NavigatePY-0001 Global Obstetrical Services Payment Policy03/29/2017
NavigatePY-0084 Telemedicine Services Payment Policy03/29/2017
NavigatePY-0004 Preferred Obstetrical Services Payment Policy03/29/2017
NavigatePY-0020 Drug Screening Payment Policy – This notification has been revised. See notification dated 08/30/2017.03/20/2017
NavigateHome Health Nursing Code Change03/15/2017
2016Date Posted
NavigateQuick Reference Guide for Non-Participating Health Partners – UPDATE11/02/2016
NavigateChange in OAC and National Medicaid Code Edits09/09/2016
NavigatePodiatry 10-Day Quantity Limit for Prescribing Opioids09/08/2016
NavigateNew Genetic Testing - Polymerase Chain Reaction Payment Policy08/25/2016
NavigateCite AutoAuth Expansion for Inpatient Authorizations08/23/2016
NavigateUpdated Sexually Transmitted Infection Policy08/19/2016
NavigateUpdated Interventional Pain Mgt Policies08/19/2016
NavigateZika Virus Benefit Summary08/19/2016
NavigateUpdated EPSDT Claim Acceptance Criteria07/28/2016
NavigateSuspension of EPSDT Claim Submission Criteria07/22/2016
Navigate10-Day Quantity Limit for Prescribing Opioids07/11/2016
NavigateNotice of Medical Documentation Requirement for Claim Modifiers06/14/2016
NavigateSpring 2016 Health Partner Education Forums04/22/2016
NavigateChange in LCD Procedure Code Edits – UPDATE04/14/2016
NavigateUpdate on Appropriate Use of G Codes03/31/2016
NavigateHome Infusion Therapy Prior Authorization Requirements, Pharmacy Criteria and Billing Guidelines03/25/2016
NavigateCurbing Opioid Overdose with NaloxoneUPDATE03/14/2016
NavigatePaper Claims Processing: Rendering and Billing NPI Requirements03/07/2016
NavigateChange in LCD Procedure Code Edits – This notification has been revised. See notification dated 04/14/2016.03/04/2016
NavigateUpdate on Billing Guidelines for Healthchek (EPSDT) Claims02/26/2016
NavigateAdditional Dental Handbook Updates for 201602/03/2016
NavigateDeadline Extended for Healthchek (EPSDT) Claims Processing Guidelines01/29/2016
NavigateChange in Behavioral Health Clinical Guidelines01/20/2016
New Facility Code Edits for Claims – This notification was canceled and removed 03/03/2016.01/07/2016
NavigateHealthchek (EPSDT) Claims Processing Guidelines12/31/2015
NavigateMyCare Coordination of Benefits (COB) Change12/18/2015
NavigateVision Benefit Change (Transitions Lenses)12/04/2015
NavigateDental Handbook Updates for 201612/01/2015
NavigateVision Benefit Change Update11/18/2015
NavigateHealth Partner Network Notification11/17/2015
NavigateICD-10 Qualifiers11/12/2015
NavigateCurbing Opioid Overdose with NaloxoneSee notification dated 03/14/2016.11/03/2015
NavigateImproved Provider Directory! Your help is needed!10/29/2015
NavigateQuick Reference Guide for Non-Participating Providers – This notification has been revised. See notification dated 11/02/2016.10/27/2015
NavigateCredentialing Process10/19/2015
NavigateVision Benefit ChangeSee notification dated 11/18/2015.09/29/2015
NavigateICD-10 Coding Guidelines Available from CMS09/16/2015
NavigateGetting Ready for ICD-1009/09/2015
NavigateNew Facility Code Edits for Claims09/03/2015
NavigateCMS Posts ICD-10-CM and PCS Code Lists08/13/2015
NavigateCMS and AMA Issue FAQs to Clarify ICD-10 Preparation Guidance08/06/2015
NavigateNotification of Nurse & Aide Service Rate Modernization Changes08/03/2015
NavigateHealthcare Clinic at Select Walgreens Now Accepting CareSource Members07/28/2015
NavigateNew Requirements for Corrected Claims Submissions Effective August 20, 201507/22/2015
NavigateCMS Creates Countdown Video, Infographic to Ease ICD-10 Transition07/22/2015
NavigateHealthSpot Locations Open for Ohio Medicaid Members – This notification was rescinded 12/31/15.07/15/2015
NavigateHome Health and Hospice ICD-10 Coding Training Opportunity07/15/2015
NavigateCMS and AMA Partner on ICD-10 Preparations07/10/2015
NavigateCMS Case Studies Available to Explore ICD-10 Concepts06/11/2015
NavigateCareSource Webinar, CMS Videos and Call Available for ICD-10 Prep06/04/2015
NavigateSubmit Claims Online Through Provider Portal06/01/2015
NavigateODM offers ICD-10 Coding Practice Opportunity05/21/2015
NavigateICD-10 Readiness Assessment05/14/2015
NavigateSummary of MyCare Ohio Services Requiring Prior Authorization05/12/2015
NavigateRevised Clinical Supporting Documentation Policy05/06/2015
NavigateRoad to 10 Resource for ICD-10 Implementation04/30/2015
NavigateTransition of Care (TOC) for MyCare Extended for Community Mental Health Centers (CMHCs)04/23/2015
NavigatePediatric Clinical Guideline04/15/2015
NavigateCite Auto Auth04/13/2015
NavigatePrior Authorization for Pain Management and CPAPs04/08/2015
NavigatePrimary Care Rate Increase (PCRI) Ending04/08/2015
NavigateICD-10 Webinars Scheduled04/06/2015
NavigateICD-10 Transition Tips03/30/2015
NavigateUpdated Health Partner Dental Handbook Now Online03/03/2015
Navigate2015 Ohio Provider Manual Now Available02/23/2015
NavigateOffice of Health Transformation Payment Innovation02/20/2015
NavigateEDI Submission of Corrected Claims02/16/2015
NavigateElectronic Submission of Coordination of Benefits (COB) Claims02/12/2015
NavigateMyCare Coordination of Benefits (COB) Change for Specific Provider Types02/06/2015
NavigateMyCare Explanation of Payment (EOP) Correction01/30/2015
NavigateCareSource Dental Provider Updates01/23/2015
NavigateMyCare Bad Debt Reports01/15/2015
NavigateALERT: ICD-10 Transition Webinar12/15/2014
NavigateUPDATE – ICD-10 Training Needs and Provider Checklist11/07/2014
NavigateText4Baby Service Launches for Ohio Medicaid Members10/28/2014
NavigateMyCare Ohio Enrollment Changes10/14/2014
NavigateALERT: MITS Scheduled Downtime October 10 6PM until October 14 6AM10/08/2014
NavigateApria Terming as DME Provider10/03/2014
NavigateCareSource Advantage (HMO SNP) Non-Renewal10/01/2014
NavigateState of Ohio Clarifies FQHCs, RHCs not Eligible for PRCI09/29/2014
Navigate7 Day Follow-up After Hospitalization for Mental Illness09/19/2014
NavigateUpdate on Autism in Ohio08/20/2014
NavigatePrimary Care Rate Increase Update08/13/2014
NavigateMyCare Educational Forums08/01/2014
NavigateCoordination of Dental/Orthodontics Benefits07/18/2014
NavigateOhio Medicaid Pregnancy Test Kit Initiative07/16/2014
NavigateNew Online Interactive Health Risk Assessment for OH Medicaid and CareSource Just4Me Members07/01/2014
NavigateOH Medicaid Vision Benefit Update06/24/2014
NavigateClaims Processing: Rendering Provider NPI Requirement04/08/2014
NavigateFee Schedule Resources and Links04/08/2014
NavigateICD-10 Implementation Delayed One Year04/07/2014
NavigateReminder to Refer to Participating Providers03/19/2014
NavigateICD-10 OH Medicaid Provider Q&A03/05/2014
NavigateInfluenza CPT Coding Change02/21/2014
NavigateICD-10 Provider Readiness Assessment Survey01/30/2014
NavigateChange to DRG Payment Process01/17/2014
NavigateNew CMS-1500 Claim Form01/03/2014
NavigateSNP Prior Authorization High Tech Radiology12/31/2013
NavigateEnhanced Primary Care Payment12/20/2013
NavigateCareSource Just4Me Resources Available on www.caresource.com12/19/2013
NavigateICD-10 OH Medicaid Provider Q&A12/13/2013
NavigateAmericans with Disabilities Act (ADA) Compliance12/12/2013
NavigateScreening, Brief Intervention, and Referral to Treatment (SBIRT)12/06/2013
NavigateNEW CareSource Provider E-Communication System11/21/2013
NavigateNew Facility Code Edits for Hospital Claims11/14/2013
NavigateQuick Reference Guide for Non-Participating Providers10/21/2013
NavigateICD-10 Training Needs and Provider Checklist10/17/2013
NavigateSynagis Prior Authorization Procedure10/02/2013
NavigateProvider Issue Resolution Process09/04/2013
NavigateFibromyalgia Medication Cost Comparison08/21/2013
NavigatePayment Policies Page Added to www.caresource.com07/31/2013
NavigateICD-10 Compliance Requirement effective October 1, 201407/12/2013
NavigateCredentialing of Physician Assistants (PAs) and Advanced Practice Nurses (APNs)07/11/2013
NavigateHealth Services Advisory Group (HSAG) Survey Calls06/24/2013
NavigateFive Things to Know About Ohio Medicaid Changes06/21/2013
NavigateSpecialty Pharmacy Network Reduction05/20/2013
NavigateOnline Drug Formulary Search Tool05/08/2013
NavigatePharmacy Tips: Go Generic!05/07/2013
NavigateProvider Information Maintenance Reminder04/02/2013
NavigateShort Fill for Oncology Medications, Phase 203/29/2013
NavigateFluoride Varnish Application Code Change03/20/2013
NavigateAdditional Requirements for Fixed Wing and Helicopter Air Ambulance Operators03/15/2013
NavigateShort Fill for Oncology Medications03/05/2013
NavigateCareSource Available on Availity Portal01/23/2013
NavigateOutpatient Facility Claims and Requirements of Modifier 2501/31/2013

NavigateOutcomesMTM Provides Medication Therapy Management Services for CareSource Advantage – Effective 01/01/1312/27/12
NavigateCareSource Policy on Co-Surgeons and Modifier -62 Billing and Reimbursement12/10/12
NavigateCareSource Policies on Facet Joint and/or Joint Nerve Injection and Sacro-iliac Joint Injection12/03/12
NavigateNon-Par Provider Quick Reference Guide11/29/12 is all NEW!11/26/12
Changes to CareSource Coordination of Benefits (COB) Policy – Effective 11/05/1211/05/12
Termination of CareSource Advantage Contract; Continuation of CareSource Medicaid Contracts11/02/12
CareSource Receives NCQA Accreditation11/02/12
Enhanced Dental Management Portal Functionality and Claims Processing – Effective 11/26/1210/26/12
Claims Payment and New EFT Enrollment Authorization Agreement Form – Effective 11/26/1210/26/12
CareSource Now Available on Availity® Portal10/22/12
Dental Claims Payment and New EFT Enrollment Authorization Agreement Form10/19/12
CareSource Policy regarding CMS NCD/LCD Policies10/16/12
Enhanced Providers Who Administer Synagis® (palivizumab) – Effective 11/01/1210/09/12
Enhanced Dental Management Services and Upcoming Educational Webinars10/02/12
Electronic Submission of Coordination of Benefits (COB) Claims – Effective 09/17/1209/17/12
NavigatePost Stabilization Care Services09/10/12
Easier-to-Use Membership Lists on the Provider Portal09/07/12
Provider Access Standards – Reminder08/15/12
Outpatient Reimbursement, Revenue Codes 250, 270, 636 – Effective 08/01/1207/31/12
Provider Satisfaction Survey – Coming in September07/27/12
New Medication Therapy Management Program07/13/12
ODJFS J Codes Covered for ODMH and ODADAS Providers07/11/12
CareSource Facility Surgical Edit PolicyRescinded in 2013, see Anesthesia Payment Policy07/11/12
CareSource Contracting and Credentialing of Physician Assistants07/11/12
New Coordination of Benefits (COB) Policy – Under Revision 10/10/1206/25/12
Members Taking Nexium, Dexilant, Aciphex06/07/12
ODJFS Updated Sterilization and Hysterectomy Forms06/04/12
CareSource Facility Surgical Edit Policy05/31/12
Update on Provider ID Numbers and Legacy ID on Claims04/20/12
NDC Code Requirements for Professional Claims04/06/12
CareSource MUE Lab Code Policy04/10/12
Reminder to Submit Appropriate Provider ID Numbers on 5010 Claims04/06/12
Providers Who Administer Synagis® (palivizumab)04/05/12
A Quick Reference Guide: Improving the Patient Experience04/04/12
Care Transition Programs04/02/12
New Abbott Diabetes Care Program03/23/12
Updated Timely Filing Rules 03/15/12
New Diabetic Supplier – Abbott Laboratories02/14/12
Provider/Group Change Request Form Updated02/03/12
Individual Claim Payment of $500,000 and Higher01/31/12
Preferred Specialty Pharmacy Provider01/24/12
Update on 5010 Clearinghouse Claims Transactions and Issues01/20/12
CareSource Pharmacy Policy on Stolen Controlled Substances01/19/12

NavigateTips for 5010 Success: Submit Legacy ID & Correct Remittance Address12/30/11
NavigateODJFS/CareSource Reimbursement Changes for 201212/22/11
NavigateRadiation Safety and Most Frequently Requested Advanced Imaging Procedures12/13/11
NavigateNew Provider Portal Updates11/22/11
NavigatePharmacy Transition Period Reminder11/15/11
Revised CareSource Venipuncture Policy10/28/11
NavigateRefraction Policy10/28/11
NavigateRevised Clinical Supporting Documentation Policy10/28/11
NavigateMedically Unlikely Edit (MUE) Policy for code 8834210/28/11
NavigateCareSource Trading Partners Submitting EDI 837 Claims10/25/11
NavigateProviders Who Administer Synagis® (palivizumab)10/17/11
NavigateSeptember 26 Check Write Delayed for Paper Checks / EOPs10/07/11
NavigateNew Benefit Limits Feature on the CareSource Provider Portal09/30/11
NavigateQuick Reference Guide for Non-Participating Providers09/26/11
NavigatePrescription Drug Coverage Changing for Members of Ohio Medicaid09/16/11
NavigateElective Labor and Delivery Prior to 39 Weeks Gestation09/08/11
NavigateEnhanced Dental Management Services09/06/11
NavigateElectronic Funds Transfer – Now Available for All Ohio Providers08/12/11
NavigateCareSource Plan for 5010 Transition07/26/11
NavigateOhio Debarred Attestation07/18/11
NavigateNDC Requirements for Physician Administered Drugs in an Office Setting07/15/11
NavigateOhio Passes House Bill 93 on Prescription Drug Abuse06/27/11
Navigate3-day Payment Window for Outpatient Svcs Treated as Inpatient Svcs06/24/11
NavigateRequesting a Contract and Updating Provider Information Changes06/02/11
Trigger Point Injection Policy05/25/11
NavigateFacet Joint and/or Joint Nerve Injection Policy05/25/11
NavigateEpidural Steroid and Selective Transforaminal Epidural Injections05/24/11
NavigateCareSource Medicaid DME and Modifier Policy05/23/11
NavigateODJFS Supports Electronic Health Records Incentive05/16/11
NavigatePA Changes to Select Specialty Medications and Pain Management Procedures05/16/11
NavigateEnhanced Find a Doctor online search tool05/16/11
NavigateRevised Immunization and Administration Billing Policy05/13/11
NavigateEnhanced Disease Management Program05/2011
NavigateMember Education Strategies on Smoking Cessation04/2011
NavigateNew PA Changes to Select Specialty Medications and Pain Management Procedures04/2011
NavigateClinical Supporting Documentation Policy04/2011
NavigateNew Improved Explanation of Payment Form04/2011
NavigateCareSource Plan for 5010 Transition04/2011
NavigateEHR Incentive Program03/2011
NavigateUpdated Panel Closure for Select Provider Types: Podiatrists, Chiropractors03/2011
NavigateTherapy Billing - Revised03/2011
NavigateFacility Inpatient Reimbursement – Now Based on Admit Date03/2011
NavigateCareSource Changes Transportation Vendor for Members02/2011
NavigateAdvanced Imaging Services Need NIA Privileges02/2011
NavigateChange to Flu Codes for Special Needs Plan (SNP) Members01/2011
NavigateAPN Medicare Pricing/CMS Methodology01/2011
NavigateAPN Medicaid Pricing/ODJFS Methodology01/2011
NavigateProvider Survey – Going on Now!01/2011
NavigateModifier Definitions01/2011
NavigateCAHPS Survey Results01/2011
NavigateWhat Constitutes a Material Change to an Existing Contract01/2011
NavigateDirect Access for Case Management/member needs now 24/712/2010
NavigateImportant Reminder on Montgomery County Care Program12/2010
NavigateCareSource Medical Claim Edit z60 – Not a Primary Diagnosis12/2010
NavigateClaim Overpayment Recoupment Policy12/2010
NavigateMultiple Surgery Procedures for Facility and Professional Claim Submissions12/2010
NavigateClaim Reprocessing Policy due to Systemic Errors12/2010
NavigateFDA Withdraws Propoxyphene (Darvocet) from the Market12/2010
NavigateStatewide Coverage for Vision Labs10/2010
NavigatePanel Closure for Select Provider Types10/2010
NavigateClaim Overpayment Recoupment Policy10/2010
NavigatePodiatry Services Policy10/2010
NavigateCareSource Code Editing10/2010
NavigateReprinted September 11, 2010 Explanation of Payment (EOPs)09/2010
NavigateTimely Filing Revisions08/2010
NavigateAppealing Sterilization Claims08/2010
NavigatePrevnar 13 Reimbursement – Backdated from March 18, 201008/2010
NavigateMember Benefits Based on Calendar Year07/2010
NavigateProfessional Developmental Testing Services Billing & Reimbursement Policy07/2010
NavigateConfidential Provider Information and Unsecured Emails07/2010
NavigatePayment Policy for Evaluation & Management Services Provided During Global Surgery Period07/2010
NavigateL-code Changes for 201007/2010
NavigateAdvanced Practice Nurses to be Contracted as Primary Care Providers05/2010
NavigateServices Requiring Prior Authorization02/2010
NavigateTop Claim Denials02/2010
NavigateCorrected Claims02/2010
NavigateHemoglobin and HealthChek Screening Visits02/2010
NavigateRefractive Service Codes02/2010
NavigatePrior Authorization Waived for Skilled Home Visits01/2010