...health plan reporting, annual Healthcare Effectiveness Data and Information Set (HEDIS®). In addition, Marketplace members complete the annual Quality Health Plan (QHP) Enrollee Survey to capture member perspectives on health...

...CareSource of members who may benefit from case management. Please see the “Member Support Services and Benefits” section on how to refer members for case management. In addition, CareSource PCPs...

...the member ID card is available in the Member ID Card Flier. Member Consent When you check eligibility on the Provider Portal, you can also determine if a member has...

...CareSource determines, or the provider indicates in making the request on the member’s behalf or supporting the member’s request, that the standard resolution time frame could seriously jeopardize the member’s...

...if the member is suffering from a serious condition that requires urgent treatment. Members may also submit a formulary exception via phone, fax or an online form – Member Exception...

...HNA included with their new member packet. It can be returned in the enclosed self-addressed, postage paid envelope. *The reward is issued through the MyHealth program. Members can find additional...

...members. CareSource PASSE members are informed of their rights and responsibilities via their member handbook. Please review our member rights and responsibilities and ensure your practice is in compliance. We...

...to the Member Handbook for a list of covered services. You can also ask your care coordinator or call Member Services to have a printed copy of the member handbook...

...Members may access Member Services by calling our toll-free number, 1-833-230-2099, 7 a.m. to 7 p.m. (TTY for the hearing impaired: 1-800-743-3333) and following the menu prompts. Members may access...

...mismatch How to Fix: Either the member had the wrong sex identified on the claim submission, or the member’s address on the claim does not match the member’s address in...