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 UPDATE - Prior Authorization Requirements	12/31/2020
Navigate Transplant Services Reimbursement	12/30/2020
Navigate Introducing New Prior Authorization Procedure Code Look-Up Tool	12/17/2020
Navigate SolarWinds Cyberattack	12/16/2020
Navigate Nursing Facility Assessment Tool	12/09/2020
Navigate Mandatory Medicaid Number Requirement	12/04/2020
Navigate 2021 Prior Authorization List Reminder	12/01/2020
Navigate Opioid Treatment Program Reimbursement – This notification has been revised. See notification dated 02/26/2021.	12/01/2020
Navigate Policy Updates December 2020	12/01/2020
Navigate Definitive Urine Drug Testing Billing Update	11/30/2020
Navigate ACT/IHBT Disenrollment Expectations	11/17/2020
Navigate Policy Updates November 2020	11/01/2020
Navigate Quarter 3 Provider Portal Updates	10/28/2020
Navigate Importance of the Flu Vaccination	10/21/2020
Navigate Updates to MA/D-SNP, MyCare Prior Authorization List	10/16/2020
Navigate Custodial Care Place of Service Billing	10/06/2020
Navigate Group Billing Guidance	10/06/2020
Navigate 2020 Quarter 2 Provider Portal Updates	10/05/2020
Navigate National Provider Identifier Requirement Reminder – UPDATE	09/28/2020
Navigate Claim Payment Advice (835) Enhancements	09/23/2020
Navigate Emergency BH Hospitalization Initial Medical Necessity Reviews	09/22/2020
Navigate Home Health Value Code Requirement	09/16/2020
Navigate Hospice Claim Modifier Requirement	09/11/2020
Navigate Appeal and Payment Dispute Timely Filing Deadline	09/10/2020
Navigate Claim Remittance Delay	09/03/2020
Navigate Enhanced Claim Editing Implementation	09/01/2020
Navigate Policy Updates September 2020	09/01/2020
Navigate Transition of Care Update	08/17/2020
Navigate Care Plan Disruption on Provider Portal	08/06/2020
Navigate 2020 Global Quality Enhancer Program	07/31/2020
Navigate National Provider Identifier Requirement – This notification has been revised. See notification dated 09/28/2020.	07/28/2020
Navigate Enhancements to Prior Authorizations on Provider Portal – UPDATE	07/27/2020
Navigate Opioid Treatment Program Nasal Narcan Billing Guidance	07/24/2020
Navigate Durable Medical Equipment Billing Resource Tool	07/23/2020
Navigate Provider Directory Information Attestation	07/22/2020
Navigate Transition to Guiding Care Announcement	07/22/2020
Navigate Opioid Treatment Program Reimbursement Update – UPDATE	07/16/2020
Navigate Risk Adjustment Coding Education	07/15/2020
Navigate CBHC Maximum Units Claim Denials	07/13/2020
Navigate Waiver Claims and ICD-10 Coding	07/13/2020
Navigate Interactive Voice Response (IVR) Enhancements for Providers	06/25/2020
Navigate Adult Day Services Code Change	06/23/2020
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 Accurate ICD-10 Coding	05/26/2020
Navigate Holiday Claim Remittance Delays	05/19/2020
Navigate DME Code Edits	05/15/2020
Navigate Diabetes Self-Management Training	05/15/2020
Navigate Policy Updates May 2020	05/01/2020
Navigate Provider Portal Claims Quick Start Guide – UPDATE	04/29/2020
Navigate Substance Use Disorder Residential Claim Denials	04/20/2020
Navigate Designation of Availity as Exclusive EDI Gateway	04/15/2020
Navigate Correct Payer ID for Claims Submissions	04/06/2020
Navigate Recent Provider Portal Updates	03/30/2020
Navigate FQHC and RHC Provider Billing Reminder	03/27/2020
Navigate Model of Care Training Requirements – UPDATE	03/27/2020
Navigate Therapy Provider Credentialing Change	03/24/2020
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 National Provider Identifier Requirement	03/11/2020
Navigate Consent Forms Reminder	03/05/2020
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	02/19/2020
Navigate Annual Notice of Requirements	02/19/2020
Navigate Patient-Driven Groupings Model Implementation	02/19/2020
Navigate Prenatal Risk Assessment Forms	02/19/2020
Navigate Electronic Visit Verification Correction	02/18/2020
Navigate Instructions on Attaching Medical Records in Provider Portal	02/07/2020
Navigate Avastin Claims Denied Incorrectly	02/07/2020
Navigate EAPG Claims Status	01/29/2020
Navigate Provider Model of Care Training – This notification has been revised. See notification dated 03/27/2020.	01/29/2020
Navigate Opioid Treatment Program Reimbursement – This notification has been revised. See notification dated 07/16/2020.	01/28/2020
Navigate Recent Provider Portal Updates	01/28/2020
Navigate Paper Checks Dated 1/21, 1/22, 1/23	01/27/2020
Navigate Payment for Laboratory Services Furnished by FQHCs or RHCs	01/21/2020
Navigate Inpatient Facility Claims Guidelines	01/20/2020
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

2019	Date
Navigate Guidelines for Properly Reporting Billing Provider Address	12/26/2019
Navigate Register with New Payment Partner ECHO Health by December 13 – Deadline Extended Again!	12/02/2019
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 Important Provider Billing Address Reminder	11/05/2019
Navigate Dual-Eligibility Billing Reminder	10/31/2019
Navigate Out of Network Hospice Providers Reminder	10/23/2019
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 Patient-Driven Payment Model Reminder	09/13/2019
Navigate National Provider Identifier for Ordering, Referring, and Prescribing Providers	09/10/2019
Navigate Important Inpatient Covered Days Billing Reminder	09/10/2019
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 SUD Partial Hospital Program (PHP)	08/27/2019
Navigate Durable Medical Equipment (DME) Recoveries	08/26/2019
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 Community Behavioral Health Claim Issue Trends and Guidance	08/14/2019
Navigate Electronic Visit Verification Update	08/09/2019
Navigate 2019-2020 Ohio Provider Manual Now Available	08/06/2019
Navigate Assisted Living, Home Health and Hospice Billing Best Practices	07/31/2019
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 Duplicate Modifier on the Claim Service Line	07/17/2019
Navigate Post-Payment Audit Update	07/12/2019
Navigate Provider Dispute Process	07/05/2019
Navigate Multi-Factor Authentication Scheduled for SKYGEN CWP	06/21/2019
Navigate Dental Code D9230 Payment Policy Update	06/14/2019
Navigate Dental Sedation Codes Payment Policy Reminder	06/14/2019
Navigate Non-Covered Dental Service Code Payment Policy Reminder	06/14/2019
Navigate Duplicate Claim Denials Review	06/14/2019
Navigate Prior Authorization Enhancements for Observation Stays	06/13/2019
Navigate 2019 Dental Procedure Code Updates	06/10/2019
Navigate Electronic Visit Verification Training Update	06/10/2019
Navigate Inpatient Hospital Pre-payment Claims Reviews - Revised 6/6/2019	06/03/2019
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 Community Behavioral Health Claim Issue Trends and Guidance	05/28/2019
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 Claim Appeals Initial Determination for Payment	05/06/2019
Navigate High Cost Radiology Services/NIA Authorization Denial for Hospitals	05/06/2019
Navigate Electronic Visit Verification Training Update	05/06/2019
Navigate Access Standards Update	05/06/2019
Navigate MyCare Waiver Provider Signature Policy Reminder	04/26/2019
Navigate Statewide Hepatitis A Outbreak Information	04/12/2019
Navigate Enhancements to Delivery and Newborn Notifications – UPDATE	03/28/2019
Navigate Waiver Services Prior Authorization Reminder	03/15/2019
Navigate Electronic Visit Verification Training Update	03/12/2019
Navigate Provider Portal Survey	03/07/2019
Navigate Authorization Requirements for Skilled Nursing Facility Stays	02/26/2019
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 Policy Updates March 2019	01/24/2019
Navigate Diagnosis Related Group (DRG) Validation Audits	01/21/2019
Navigate Request Interpreter Services Online	01/21/2019

2018	Date
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	12/18/2018
Navigate Issues with Claim Denying for National Drug Code (NDC)	12/14/2018
Navigate Changes to Billing Codes for Personal Care Aide Services – UPDATE	12/12/2018
Navigate Remittance Delay for Wednesday, December 5, 2018 Payment Cycle	12/07/2018
Navigate MyCare Waiver Provider Signature Policy Network Notification	12/4/2018
Navigate Electronic Visit Verification Reminder	11/14/2018
Navigate Policy Updates January 2019	11/01/2018
Navigate Code Advisor Network Notification	10/23/2018
Navigate Enhancements to the Waiver Portal	10/11/2018
Navigate Electronic Provider Appeals Required	10/02/2018
Navigate Changes to Billing Codes for Personal Care Aide Services	10/01/2018
Navigate Ambulance Overpayments and Incorrect Payments Recovery	09/27/2018
Navigate Q3 2018 Payment Update	09/27/2018
Navigate DME Overpayments and Incorrect Payments Recovery Notice	09/27/2018
Navigate Home Health Overpayments and Incorrect Payments Recovery Notice	09/27/2018
Navigate Physician Assistant Overpayments and Incorrect Payments Recovery Notice	09/27/2018
Navigate Duplicate Claim Processing Update	09/01/2018
Navigate Well-Child Care	08/27/2018
Navigate ODM Medicaid Number Requirement	08/27/2018
Navigate Signatures No Longer Needed for Medicaid Addendum Attachments for Provider Maintenance Updates	08/21/2018
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 Inventory Reduction Progress and Compliant Process	07/10/2018
Navigate Increase Frequency in Claim Payment Processing	07/03/2018
Navigate New Address for Refund Checks	07/03/2018
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	01/12/2018

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 Enhanced Ambulatory Patient Groups (EAPG) Billing Methodology Supersedes CareSource Payment Policies	11/07/2017
Navigate Deactivation of MyCare Mailbox	10/11/2017
Navigate Update Regarding Enhanced Ambulatory Patient Group (EAPG) Billing Payment Methodology	10/10/2017
Navigate Clinical Appeals Require Member Consent	09/22/2017
Navigate Model of Care Training Required	09/21/2017
Navigate Update on Processing Claims for Enhanced Ambulatory Patient Groups – UPDATE	09/01/2017
Navigate Drug Screening Reimbursement Policy – This notification has been revised. See notification dated 12/01/2017.	08/30/2017
Navigate Notice of Medicare Non-Coverage (NOMNC)	08/28/2017
Navigate Lift Chair Coverage and Prior Authorization	08/28/2017
Navigate Service Plan Letters	08/21/2017
Navigate Submitting Claims for T1019 Personal Care	08/21/2017
Navigate Passport vs. Medicaid Payment Structure	07/31/2017
Navigate Announcing Enforcement of Enhanced Ambulatory Patient Groups Billing Guidelines – This notification has been revised. See notification dated 09/01/2017.	07/27/2017
Navigate Behavioral Health Respite Care Services for Children	07/17/2017
Navigate Changes to the Home Modification Process	07/17/2017
Navigate Validation of Service Narrative	07/17/2017
New Service for Waiver Members – This notification has been canceled and removed 7/11/2017.	06/29/2017
Navigate Summer Waiver Provider Forums	06/23/2017
Navigate Retro Prior Authorizations	05/31/2017
Navigate Service Plan Enhancements	05/30/2017
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-0142 Three-Day Window Payment Policy	04/11/2017
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 Frequently Asked Questions (FAQ) for Long Term Care Nursing Facilities	02/17/2017
Navigate Provider Portal Attestation Enhancements	02/08/2017
Navigate 2016 MyCare Bad Debt Reconciliation	02/08/2017
Navigate Service Rate Changes	01/24/2017
Navigate New Attestation for Claim Submission for Waiver Health Partners	01/23/2017

2016	Date Posted
Navigate Provider Portal Training / Learn about Prior Authorization Changes	12/22/2016
Navigate Addition of Prior Authorization for Part B Therapy	12/07/2016
Navigate Quick Reference Guide for Non-Participating Health Partners – UPDATE	11/02/2016
Navigate Home Health Services: New Regulatory Requirements for Retired/ New Codes	10/26/2016
Navigate Billing for Waiver Services	10/13/2016
Navigate Ohio Revised Code 5165.38 - Provider Agreement Terminations	10/07/2016
Navigate Payment Policy for Independent Providers	09/27/2016
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 Notice of Medical Documentation Requirement for Claim Modifiers	06/14/2016
Navigate Spring 2016 Health Partner Education Forums	04/22/2016
Navigate Vision Benefit Change	04/05/2016
Navigate Claims Submission for Waiver Services Made Easier	04/05/2016
Navigate Update on Appropriate Use of G Codes	03/31/2016
Navigate Patient Liability Reconciliation Spreadsheets	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 Update on Billing Guidelines for Healthchek (EPSDT) Claims	02/26/2016
Navigate Deadline Extended for Healthchek (EPSDT) Claims Processing Guidelines	02/24/2016
Navigate Clarification on the CareSource Transportation Benefit	02/24/2016
Navigate 2015/2016 MyCare Ohio Opt-In Coinsurance for SNF Claims	02/04/2016
Navigate Additional Dental Handbook Updates for 2016	02/03/2016
Navigate Rate Calculations for Claims in Excess of 40 Hours in a Week	01/25/2016
Navigate Change in Behavioral Health Clinical Guidelines	01/20/2016
New Facility Code Edits for Claims – This notification has been canceled and removed 3/3/2016.	01/07/2016

2015	Date Posted
Navigate Healthchek (EPSDT) Claims Processing Guidelines	12/31/2015
Navigate MyCare Coordination of Benefits (COB) Change	12/18/2015
Navigate Dental Handbook Updates for 2016	12/01/2015
Navigate Health Partner Network Notification	11/17/2015
Navigate ICD-10 Qualifiers	11/12/2015
Navigate Curbing Opioid Overdose with Naloxone – See notification dated 3/14/2016.	11/03/2015
Navigate Improved Provider Directory! Your help is needed!	10/29/2015
Navigate Quick Reference Guide for Non-Participating Providers – This notification has been revised. See notification dated 11/2/2016.	10/27/2015
Navigate Credentialing Process	10/19/2015
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 Notification of Nurse & Aide Service Rate Modernization Changes	08/03/2015
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 ODM offers ICD-10 Coding Practice Opportunity	05/21/2015
Navigate ICD-10 Readiness Assessment	05/14/2015
Navigate Summary of MyCare Ohio Services Requiring Prior Authorization	05/12/2015
Navigate Revised Clinical Supporting Documentation Policy	05/06/2015
Navigate Road to 10 Resource for ICD-10 Implementation	04/30/2015
Navigate Transition of Care (TOC) for MyCare Extended for Community Mental Health Centers (CMHCs)	04/23/2015
Navigate Prior Authorization for Pain Management and CPAPs	04/08/2015
Navigate Primary Care Rate Increase (PCRI) Ending	04/08/2015
Navigate ICD-10 Webinars Scheduled	04/06/2015
Navigate ICD-10 Transition Tips	03/30/2015
Navigate Updated Health Partner Dental Handbook Now Online	03/03/2015
Navigate 2015 Ohio Provider Manual Now Available	02/23/2015
Navigate Office of Health Transformation Payment Innovation	02/20/2015
Navigate EDI Submission of Corrected Claims	02/16/2015
Navigate Electronic Submission of Coordination of Benefits (COB) Claims	02/12/2015
Navigate MyCare Coordination of Benefits (COB) Change for Specific Provider Types	02/06/2015
Navigate MyCare Explanation of Payment (EOP) Correction	01/30/2015
Navigate CareSource Dental Provider Updates	01/23/2015
Navigate MyCare Bad Debt Reports	01/15/2015

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