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Contact Us
https://www.caresource.com/members/contact-us/Member Services We can help you: Get interpreters in the language you speak. Get printed copies of your plan materials sent to you at no charge. Learn more about your...
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Provider Resources
https://www.caresource.com/providers/provider-portal/...Disputes or Appeals Provider Disputes or Appeals View grievance requirements and time frames and submit grievances. View or Submit Update Practice Information Update Practice Information Alert us to changes in...
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General Plan Information
https://www.caresource.com/plans/marketplace/plan-documents/general-plan-information/...Member Appeals P.O. Box 1947 Dayton, OH 45401 Toll Free: 937-487-0629 (for Expedited Review) Fax: 937-487-0629 Expedited Fax: 937-531-2398 You may also use the secure online form on our Forms...
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Behavioral Health Carve-In
https://www.caresource.com/providers/education/patient-care/behavioral-health-carve-in/...for residential and partial hospitalization Substance Use Disorder (SUD) services. Claims Appeals Information on how to dispute or appeal a claims decision can be found on CareSource’s Provider Appeals page....
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Comprehensive Formulary
https://www.caresource.com/plans/dsnp/pharmacy/drug-formulary/...determinations and appeals can be found in the Evidence of Coverage (Chapter 9, section 6). Find this and other documents on our Plan Documents page. For more information about exceptions,...
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Updates & Announcements
https://www.caresource.com/providers/tools-resources/updates-announcements/Quick References COVID-19 information Pharmacy information, including our Preferred Drug Lists (PDLs) Medical, pharmacy, reimbursement and administrative policies We strive to make partnering with us simple. We’re aware things may...
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State Fair Hearings
https://www.caresource.com/members/tools-resources/grievance-appeal/state-fair-hearings/...letter. How do you ask for a State Fair Hearing? Address: DHS Office of Appeals and Hearings, P.O. Box 1437, Slot S101, Little Rock, AR 72203-1437 Phone: 501-682-8622 Fax: 501-404-4628...
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Caregiver Forms
https://www.caresource.com/members/tools-resources/caregiver-resources/forms/...For medical coverage: CareSource, P.O. Box 1947, Dayton, OH 45401-1947 For prescription drug coverage: Express Scripts, c/o Medicare Clinical Appeals, P.O. Box 66588, St. Louis, MO 63166-6588 See other CareSource...
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Member Rights & Responsibilities
https://www.caresource.com/plans/marketplace/plan-documents/rights-responsibilities/...health care. Candidly discuss with your doctor the appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage. Voice complaints or appeals about the plan...
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Drug Formulary
https://www.caresource.com/benefits-services__trashed/pharmacy/drug-formulary/...of the original request. Full details on coverage determinations and appeals can be found in the Evidence of Coverage (Chapter 9, section 6). Find this and other documents on our...
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Appeals