...options. WHERE TO GET CARE Forms Forms All the forms you need in one place. Find Forms Submit a Grievance or Appeal Submit a Grievance or Appeal If you are...

...out the form online. Print the form. (coming soon) Interpreter Service Request Form Tell Us (coming soon): Use this form when you would like to send us a question. You...

...you can use. Forms We want you to easily find the forms you need for your CareSource plan. Visit the Forms page to find any form when you need it....

...45401 Disease Management 1-844-438-9498 Care Management 1-855-202-0729 Referral fax: 844-417-6255 Behavioral Health 1-855-202-1058 Quality Improvement 1-855-202-1058 Appeals 1-855-202-1058 Fax: 1-937-531-2398 CareSource Attn: Health Partner Appeals-Georgia, P.O. Box 2008 Dayton OH...

...CareSource, P.O. Box 1947, Dayton, OH 45401-1947 Appeals An appeal is a request to reconsider and change the decision made or the action taken on services requested. An appeal is...

...PDF format. If you do not have Adobe Acrobat Reader, you may download it here. General Updates 2025 Date Align Provider Network Pharmacy Termination Disclosure 12/02/2025 Transition of DentaQuest and...

...Health Outcomes Survey Over and underutilization patterns and trends On an annual basis, we formally evaluate our QI program and performance metrics against set goals. Our formal results inform our...

...We can get you interpreters for sign language or in the language you speak. You can also get materials in other formats like large print, Braille or audio. This is...

...A Claim Provider Appeals Provider Appeals View appeal requirements and time frames and submit appeals. View or Submit Tools & Resources Tools & Resources Access information to help you with...

...such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. 2025 Summary of Benefits (10/01/2024) Last updated on 10/01/2024 Forms Visit the Forms page to find forms when...