...will only reimburse claims for Medicaid services. Claims for Medicare must be submitted to the plan managing the member’s Medicare benefits. Therefore, we recommend that you check member eligibility each...

...checks in accordance with 42 CFR 455.436 and must execute a single case agreement with the provider that includes the appropriate Model Addendum. If the provider is not or will...

...2020 01/28/2020 Recent Provider Portal Updates 01/28/2020 Paper Checks Dated 1/21, 1/22, 1/23 01/27/2020 EAPG Claims Status 01/22/2020 Payment for Laboratory Services Furnished by FQHCs or RHCs 01/21/2020 Policy Updates...

...training modules and more! Upcoming Events We look forward to meeting you in a future event! Be sure to check back frequently for upcoming event announcements. Go to HealthPlanResources.com to...

...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...

...services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing...

...you with these needs. Is a care coordinator the same as a DCFS caseworker? No. Your care coordinator does not replace your DCFS caseworker or any provider you have. A...

...Last updated on 12/07/2023 Step Therapy Criteria: In some cases, CareSource requires you to first try certain drugs to treat a medical condition before we will cover another drug for...

...such as the group number or member’s date of birth? Check the carrier’s website or call the carrier directly to obtain the information. We encourage all health partners to verify...

...medical procedure. Claims Forms Claim Refund Check Form Mail your refund check, this form and any other required documentation to CareSource. ECHO Health Enrollment Submit this form to enroll with...