...through routine 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...

...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...

...and/or the denied claim If filing an appeal on behalf of a member or for pre-service issues, the member’s written consent (or signed Appointment of Representative form(coming soon) for dual...

...response to Formulary drugs. The member or member’s representative can call Member Services to make the request or can complete the online Member Exception Request for Non-Formulary Medication. When a...

...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...

...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...

...member. Get a CareSource member ID Card, Plan Documents or Change Your Doctor How do I get a new CareSource member ID card? Log into your My CareSource account to...

...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...