Authorization, Claims & Appeals
We want to make it as easy as possible to conduct business with us. Our Authorization, Claims and Appeals pages share important policies and procedures for working with our plan. Here you will find how to make efficient submissions and requests with CareSource. You will also find more information on how we evaluate requests.
Please review our resources to the left, designed to help make our submission processes easier.
- Our Prior Authorization page provides information on how to submit a prior authorization request and what services require it.
- Our Claims page provides information on how to efficiently submit and receive payment for claims.
- Our Grievances & Appeals page provides information on how to submit grievances and appeals for claims or clinical decisions.
- Our Utilization Management page provides information on how CareSource evaluates the appropriateness of services rendered to members.