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Prior Authorizations & Referrals
https://www.caresource.com/plans/caresource-passe/benefits/prior-authorizations-referrals/Prior Authorization is the approval that may be needed before you get a service. It must be medically necessary for your care. Your provider will get approval for the care...
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Contact Us
https://www.caresource.com/providers/contact-us/...numbers for general questions, prior authorizations, claim inquiries and more, as well as common fax numbers and addresses. Use this list as a guide to help you find the appropriate...
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Prior Authorization
https://www.caresource.com/providers/provider-portal/prior-authorization/...Code Lookup Tool and Authorization Requirements for Medications under the Medical Benefit (coming soon). Vision Prior Authorizations For routine vision services, providers can submit prior authorizations through the Versant provider...
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Past Updates & Announcements
https://www.caresource.com/providers/tools-resources/updates-announcements/past/...New Genetic Testing - Polymerase Chain Reaction Payment Policy 08/25/2016 Cite AutoAuth Expansion for Inpatient Authorizations 08/23/2016 Updated Sexually Transmitted Infection Policy 08/19/2016 Updated Interventional Pain Mgt Policies 08/19/2016 Zika...
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Provider Manual
https://www.caresource.com/providers/tools-resources/provider-manual/Our Provider Manual is a resource for working with our health plan. This manual communicates policies and programs and outlines key information, such as claim submission, and reimbursement processes, authorizations,...
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FAQs
https://www.caresource.com/providers/education/faqs/...partners can perform a variety of functions, including checking eligibility and claim status, submitting prior authorizations and more Provider relations staff Commitment to service Member support services How can I...
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COVID-19 Information and Resources
https://www.caresource.com/providers/tools-resources/covid-19-provider-resource-center/The Public Health Emergency (PHE) for COVID-19 has ended. Services like vaccines, treatment, and testing are still available. Some rules changed, stopped, or started again. CareSource continues to watch COVID-19...
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General Plan Information
https://www.caresource.com/plans/marketplace/plan-documents/general-plan-information/...your Evidence of Coverage (EOC). You can find your EOC in your annual member material packet, or online under Plans/Plan Documents. Standard Authorizations are reviewed, and notice provided within 3...
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Student Program
https://www.caresource.com/providers/education/patient-care/pharmacy/pharmacy-community-programs/student-program/...waste, and abuse (FWA) To enable future pharmacists to find formulary information and understand the purpose of prior authorizations To positively impact the next generation of pharmacists Expectations and Responsibilities...
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Claims
https://www.caresource.com/providers/provider-portal/claims/...A One Front Door approach has been established to simplify the submission of claims and prior authorizations. Submitting Claims and Authorizations Providers can submit claims and prior authorizations in two...
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AUTHORIZATIONS