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Archived Reimbursement Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/reimbursement-policies/archived/The policies below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here. # A B C D E F G H I...
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Fraud, Waste and Abuse (FWA)
https://www.caresource.com/about-us/legal/corporate-compliance/vendor-compliance/fraud-waste-and-abuse-fwa/...for prescriptions not filled or picked up Company/Employee/Delegated Entities: Embezzling CareSource funds Misappropriation of CareSource assets Stealing CareSource property Falsifying CareSource business data and reports Receiving gifts or kickbacks from...
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Prescription Drug Formulary
https://www.caresource.com/plans/marketplace/benefits-services/pharmacy/preferred-drug-list/...CareSource Marketplace Drug Formulary 2026 CareSource Marketplace Drug Formulary 2025 CareSource Marketplace Drug Formulary 2025 CareSource Marketplace Drug Formulary 2026 CareSource Marketplace Drug Formulary 2025 CareSource Marketplace Drug Formulary 2026...
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Reimbursement Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/reimbursement-policies/...the CareSource plan. Reimbursement policies are designed to assist you when submitting claims to CareSource. They are routinely updated to promote accurate coding and policy clarification. These proprietary policies are...
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Disaster Readiness
https://www.caresource.com/members/education/planning-ahead/disaster-readiness/...special needs of family members and add items that fit your needs (such as baby items or pet food). Be sure to have your CareSource ID cards. Decide ahead of...
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Referrals & Prior Authorization
https://www.caresource.com/plans/medicaid/benefits-services/referrals-prior-authorization/...providers in the HAP CareSource network. Network or in-network provider refers to the providers who accept HAP CareSource insurance and see patients who are covered through HAP CareSource. When you...
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Pharmacy
https://www.caresource.com/plans/marketplace/benefits-services/pharmacy/CareSource covers prescription drugs that are filled at the pharmacy as part of your plan. CareSource works with our Pharmacy Innovation Partner – Express Scripts – to ensure that the...
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Preventive Care
https://www.caresource.com/members/education/preventive-care/...Smoking Cessation If you use tobacco and are ready to quit, we can help. CareSource wants to make sure you are happy and healthy. There are several health screenings your...
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Health Assessment & Screening
https://www.caresource.com/members/my-caresource-account/health-assessment-screening/...Team 1-833-230-2010 (TTY: 1-833-711-4711 or 711). Get a $50 reward through the My CareSource Rewards® for filling out the HNA within the first 30 days of enrollment. See My CareSource...
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Mail Order Drugs
https://www.caresource.com/members/tools-resources/find-my-prescriptions/mail-order-drugs/...your account, and click the Request an Rx button on the right side of the home page. Dial the Pharmacy number on the back of your CareSource member ID card,...
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