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Plan Documents
https://www.caresource.com/plans/mihealthlink/plan-documents/...form. Coverage Redetermination Request Form – If you are unsatisfied with the outcome of a coverage determination request, you can file an appeal using the redetermination form. Pharmacy Prior Authorization...
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Drug Transition Policy
https://www.caresource.com/plans/mycare-snp/benefits-services/pharmacy/drug-transition-policy/...cover the drug in the way you would like it covered. The plan will review the request and approve or deny. If denied, you may file an appeal. For questions...
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Grievances
https://www.caresource.com/members/tools-resources/grievance-appeal/grievance/...name, your member ID number, your address, phone number and any information that helps explain your problem. Mail the form or letter to: CareSource Attn: Member Grievance & Appeals P.O....
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Rights & Responsibiities
https://www.caresource.com/plans/mich/plan-documents/rights-responsibiities/...exercise your rights without adversely affecting the way the Contractor, providers, or the state treats you File a complaint, grievance or appeal as well as, to request a State Fair...
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Plan Documents
https://www.caresource.com/plans/mich/plan-documents/...by completing this form. Coverage Redetermination Request Form – If you are unsatisfied with the outcome of a coverage determination request, you can file an appeal using the redetermination form....
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Rights & Responsibilities
https://www.caresource.com/plans/mycare-snp/plan-documents/rights-responsibilities/...it. To be able to file an appeal, a grievance (complaint) or state hearing. See your member handbook for information. To be able to get all CareSource MyCare Ohio written...
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Plan Documents
https://www.caresource.com/plans/mycare-snp/plan-documents/...online or hard copy ( English | Spanish). Coverage Redetermination Request Form If you are unhappy with the result of a coverage determination request, you can file an appeal. Use...
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Food Services
https://www.caresource.com/plans/medicaid/benefits-services/additional-services/food-services/...will stay the same if you use a food service or choose not to. You can file a grievance or appeal about the food service, for example, if you are...
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Preferred Drug List
https://www.caresource.com/plans/medicaid/benefits-services/pharmacy/preferred-drug-list/...drug may not get approved. If not approved, we will send you information on how you can appeal our decision and your right to a state hearing. Gainwell uses the...
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Health Care Terms
https://www.caresource.com/members/education/health-care-terms/Learn what the terms mean that your provider uses. There are even more word meanings in your member handbook. Term Definition Inpatient Services Inpatient Services are when you spend at...
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