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.

2020Date
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
NavigateNursing Facility Assessment Tool12/09/2020
NavigateMandatory Medicaid Number Requirement12/04/2020
Navigate2021 Prior Authorization List Reminder12/01/2020
NavigateOpioid Treatment Program ReimbursementThis notification has been revised. See notification dated 02/26/2021.12/01/2020
NavigatePolicy Updates December 202012/01/2020
NavigateDefinitive Urine Drug Testing Billing Update11/30/2020
NavigateACT/IHBT Disenrollment Expectations11/17/2020
NavigatePolicy Updates November 202011/01/2020
NavigateQuarter 3 Provider Portal Updates10/28/2020
NavigateImportance of the Flu Vaccination10/21/2020
NavigateUpdates to MA/D-SNP, MyCare Prior Authorization List10/16/2020
NavigateCustodial Care Place of Service Billing10/06/2020
NavigateGroup Billing Guidance10/06/2020
Navigate2020 Quarter 2 Provider Portal Updates10/05/2020
NavigateNational Provider Identifier Requirement Reminder – UPDATE09/28/2020
NavigateClaim Payment Advice (835) Enhancements09/23/2020
NavigateEmergency BH Hospitalization Initial Medical Necessity Reviews09/22/2020
NavigateHome Health Value Code Requirement09/16/2020
NavigateHospice Claim Modifier Requirement09/11/2020
NavigateAppeal and Payment Dispute Timely Filing Deadline09/10/2020
NavigateClaim Remittance Delay09/03/2020
NavigateEnhanced Claim Editing Implementation09/01/2020
NavigatePolicy Updates September 202009/01/2020
NavigateTransition of Care Update08/17/2020
NavigateCare Plan Disruption on Provider Portal08/06/2020
Navigate2020 Global Quality Enhancer Program07/31/2020
NavigateNational Provider Identifier RequirementThis notification has been revised. See notification dated 09/28/2020.07/28/2020
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
NavigateTransition to Guiding Care Announcement07/22/2020
NavigateOpioid Treatment Program Reimbursement UpdateUPDATE07/16/2020
NavigateRisk Adjustment Coding Education07/15/2020
NavigateCBHC Maximum Units Claim Denials07/13/2020
NavigateWaiver Claims and ICD-10 Coding07/13/2020
NavigateInteractive Voice Response (IVR) Enhancements for Providers06/25/2020
NavigateAdult Day Services Code Change06/23/2020
NavigateFeedback Requested: SNF Provider Summit Ideas06/22/2020
NavigateProvider Portal Claims Submittal Enhancement06/15/2020
NavigatePolicy Updates June 202006/01/2020
NavigateAccurate ICD-10 Coding05/26/2020
NavigateHoliday Claim Remittance Delays05/19/2020
NavigateDME Code Edits05/15/2020
NavigateDiabetes Self-Management Training05/15/2020
NavigatePolicy Updates May 202005/01/2020
NavigateProvider Portal Claims Quick Start GuideUPDATE04/29/2020
NavigateSubstance Use Disorder Residential Claim Denials04/20/2020
NavigateDesignation of Availity as Exclusive EDI Gateway04/15/2020
NavigateCorrect Payer ID for Claims Submissions04/06/2020
NavigateRecent Provider Portal Updates03/30/2020
NavigateFQHC and RHC Provider Billing Reminder03/27/2020
NavigateModel of Care Training Requirements – UPDATE03/27/2020
NavigateTherapy Provider Credentialing Change03/24/2020
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
NavigateNational Provider Identifier Requirement03/11/2020
NavigateConsent Forms Reminder03/05/2020
NavigateAccess and Availability Standards03/02/2020
NavigatePolicy Updates March 202003/01/2020
NavigateFQHC Use of Uniform Billing Form UB-0402/19/2020
NavigateAnnual Notice of Requirements02/19/2020
NavigatePatient-Driven Groupings Model Implementation02/19/2020
NavigatePrenatal Risk Assessment Forms02/19/2020
NavigateElectronic Visit Verification Correction02/18/2020
NavigateInstructions on Attaching Medical Records in Provider Portal02/07/2020
NavigateAvastin Claims Denied Incorrectly02/07/2020
NavigateEAPG Claims Status01/29/2020
NavigateProvider Model of Care TrainingThis notification has been revised. See notification dated 03/27/2020.01/29/2020
NavigateOpioid Treatment Program ReimbursementThis notification has been revised. See notification dated 07/16/2020.01/28/2020
NavigateRecent Provider Portal Updates01/28/2020
NavigatePaper Checks Dated 1/21, 1/22, 1/2301/27/2020
NavigatePayment for Laboratory Services Furnished by FQHCs or RHCs01/21/2020
NavigateInpatient Facility Claims Guidelines01/20/2020
NavigatePolicy Updates January 2020UPDATE01/20/2020
NavigateProvider Payment Migration Complete01/13/2020
NavigateHigh Dollar Claims Cover SheetUPDATE01/07/2020
2019Date
NavigateGuidelines for Properly Reporting Billing Provider Address12/26/2019
NavigateRegister with New Payment Partner ECHO Health by December 13Deadline Extended Again!12/02/2019
NavigateHoliday Claim Remittance Delay11/26/2019
NavigateICD-10 Code Update11/26/2019
NavigateDelay in Claim Payments11/13/2019
NavigateImportant Provider Billing Address Reminder11/05/2019
NavigateDual-Eligibility Billing Reminder10/31/2019
NavigateOut of Network Hospice Providers Reminder10/23/2019
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
NavigatePatient-Driven Payment Model Reminder09/13/2019
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
NavigateIssue with Denials for Physical Therapy (PT) Units08/23/2019
NavigateIssues with Outpatient Claim Denials Due to Authorizations Expiring08/23/2019
NavigateCommunity Behavioral Health Claim Issue Trends and Guidance08/14/2019
NavigateElectronic Visit Verification Update08/09/2019
Navigate2019-2020 Ohio Provider Manual Now Available08/06/2019
NavigateAssisted Living, Home Health and Hospice Billing Best Practices07/31/2019
NavigateRegister with New Payment Partner ECHO Health by October 25This notification has been revised. See notification dated 09/25/201907/26/2019
NavigateDuplicate Modifier on the Claim Service Line07/17/2019
NavigatePost-Payment Audit Update07/12/2019
NavigateProvider Dispute Process07/05/2019
NavigateMulti-Factor Authentication Scheduled for SKYGEN CWP06/21/2019
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
NavigateDuplicate Claim Denials Review06/14/2019
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
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
NavigateClaim Appeals Initial Determination for Payment05/06/2019
NavigateHigh Cost Radiology Services/NIA Authorization Denial for Hospitals05/06/2019
NavigateElectronic Visit Verification Training Update05/06/2019
NavigateAccess Standards Update05/06/2019
NavigateMyCare Waiver Provider Signature Policy Reminder04/26/2019
NavigateStatewide Hepatitis A Outbreak Information04/12/2019
NavigateEnhancements to Delivery and Newborn Notifications – UPDATE03/28/2019
NavigateWaiver Services Prior Authorization Reminder03/15/2019
NavigateElectronic Visit Verification Training Update03/12/2019
NavigateProvider Portal Survey03/07/2019
NavigateAuthorization Requirements for Skilled Nursing Facility Stays02/26/2019
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 Notifications02/01/2019
NavigateHepatitis A Prevention01/29/2019
NavigatePolicy Updates March 201901/24/2019
NavigateDiagnosis Related Group (DRG) Validation Audits01/21/2019
NavigateRequest Interpreter Services Online01/21/2019
2018Date
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
NavigateChanges to Billing Codes for Personal Care Aide ServicesUPDATE12/12/2018
NavigateRemittance Delay for Wednesday, December 5, 2018 Payment Cycle12/07/2018
NavigateMyCare Waiver Provider Signature Policy Network Notification12/4/2018
NavigateElectronic Visit Verification Reminder11/14/2018
NavigatePolicy Updates January 201911/01/2018
NavigateCode Advisor Network Notification10/23/2018
NavigateEnhancements to the Waiver Portal10/11/2018
NavigateElectronic Provider Appeals Required10/02/2018
NavigateChanges to Billing Codes for Personal Care Aide Services10/01/2018
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
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
NavigateClarification of Indiana Network Closure Communication07/30/2018
NavigateIncreasing Claim Payment Processing FrequencyUPDATE07/27/2018
NavigateInventory Reduction Progress and Compliant Process07/10/2018
NavigateIncrease Frequency in Claim Payment Processing07/03/2018
NavigateNew Address for Refund Checks07/03/2018
NavigateUpdate to Provider Billing Address Requirements on Claims04/03/2018
NavigatePolicy Updates June 201803/30/2018
NavigateUpdate to Drug Testing PolicyUPDATE03/12/2018
NavigatePolicy Updates May 201802/28/2018
NavigateDiabetes Retinal Eye Exam01/25/2018
NavigateNew Approach to Educate and Reduce Evaluation and Management Billing Errors01/12/2018
2017Date
NavigateMarch 2018 Policy Release12/28/2017
NavigateUpdate on Drug Testing Reimbursement Policy – UPDATE12/01/2017
NavigateNotice of Change to Cardiac Services Prior Authorization Requirements11/17/2017
NavigateEnhanced Ambulatory Patient Groups (EAPG) Billing Methodology Supersedes CareSource Payment Policies11/07/2017
NavigateDeactivation of MyCare Mailbox10/11/2017
NavigateUpdate Regarding Enhanced Ambulatory Patient Group (EAPG) Billing Payment Methodology10/10/2017
NavigateClinical Appeals Require Member Consent09/22/2017
NavigateModel of Care Training Required09/21/2017
NavigateUpdate on Processing Claims for Enhanced Ambulatory Patient GroupsUPDATE09/01/2017
NavigateDrug Screening Reimbursement Policy – This notification has been revised. See notification dated 12/01/2017.08/30/2017
NavigateNotice of Medicare Non-Coverage (NOMNC)08/28/2017
NavigateLift Chair Coverage and Prior Authorization08/28/2017
NavigateService Plan Letters08/21/2017
NavigateSubmitting Claims for T1019 Personal Care08/21/2017
NavigatePassport vs. Medicaid Payment Structure07/31/2017
NavigateAnnouncing Enforcement of Enhanced Ambulatory Patient Groups Billing Guidelines – This notification has been revised. See notification dated 09/01/2017.07/27/2017
NavigateBehavioral Health Respite Care Services for Children07/17/2017
NavigateChanges to the Home Modification Process07/17/2017
NavigateValidation of Service Narrative07/17/2017
New Service for Waiver Members – This notification has been canceled and removed 7/11/2017.06/29/2017
NavigateSummer Waiver Provider Forums06/23/2017
NavigateRetro Prior Authorizations05/31/2017
NavigateService Plan Enhancements05/30/2017
NavigateScreening and Surveillance for Colorectal Cancer04/18/2017
NavigateMM-0034, MM-0079, MM-0080 Gender Dysphoria Medical Policy04/14/2017
NavigatePY-0142 Three-Day Window Payment Policy04/11/2017
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
NavigateFrequently Asked Questions (FAQ) for Long Term Care Nursing Facilities02/17/2017
NavigateProvider Portal Attestation Enhancements02/08/2017
Navigate2016 MyCare Bad Debt Reconciliation02/08/2017
NavigateService Rate Changes01/24/2017
NavigateNew Attestation for Claim Submission for Waiver Health Partners01/23/2017
2016Date
Posted
NavigateProvider Portal Training / Learn about Prior Authorization Changes12/22/2016
NavigateAddition of Prior Authorization for Part B Therapy12/07/2016
NavigateQuick Reference Guide for Non-Participating Health Partners – UPDATE11/02/2016
NavigateHome Health Services: New Regulatory Requirements for Retired/ New Codes10/26/2016
NavigateBilling for Waiver Services10/13/2016
NavigateOhio Revised Code 5165.38 - Provider Agreement Terminations10/07/2016
NavigatePayment Policy for Independent Providers09/27/2016
NavigateCite AutoAuth Expansion for Inpatient Authorizations08/23/2016
NavigateUpdated EPSDT Claim Acceptance Criteria07/28/2016
NavigateSuspension of EPSDT Claim Submission Criteria07/22/2016
NavigateNotice of Medical Documentation Requirement for Claim Modifiers06/14/2016
NavigateSpring 2016 Health Partner Education Forums04/22/2016
NavigateVision Benefit Change04/05/2016
NavigateClaims Submission for Waiver Services Made Easier04/05/2016
NavigateUpdate on Appropriate Use of G Codes03/31/2016
NavigatePatient Liability Reconciliation Spreadsheets03/25/2016
NavigateCurbing Opioid Overdose with Naloxone – UPDATE03/14/2016
NavigatePaper Claims Processing: Rendering and Billing NPI Requirements03/07/2016
NavigateUpdate on Billing Guidelines for Healthchek (EPSDT) Claims02/26/2016
NavigateDeadline Extended for Healthchek (EPSDT) Claims Processing Guidelines02/24/2016
NavigateClarification on the CareSource Transportation Benefit02/24/2016
Navigate2015/2016 MyCare Ohio Opt-In Coinsurance for SNF Claims02/04/2016
NavigateAdditional Dental Handbook Updates for 201602/03/2016
NavigateRate Calculations for Claims in Excess of 40 Hours in a Week01/25/2016
NavigateChange in Behavioral Health Clinical Guidelines01/20/2016
New Facility Code Edits for Claims – This notification has been canceled and removed 3/3/2016.01/07/2016
2015Date
Posted
NavigateHealthchek (EPSDT) Claims Processing Guidelines12/31/2015
NavigateMyCare Coordination of Benefits (COB) Change12/18/2015
NavigateDental Handbook Updates for 201612/01/2015
NavigateHealth Partner Network Notification11/17/2015
NavigateICD-10 Qualifiers11/12/2015
NavigateCurbing Opioid Overdose with Naloxone – See notification dated 3/14/2016.11/03/2015
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 11/2/2016.10/27/2015
NavigateCredentialing Process10/19/2015
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
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
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