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Pharmacy
https://www.caresource.com/providers/education/patient-care/pharmacy/Before providing care or prescribing medicine for your patients, please review the CareSource® MyCare Ohio (HMO D-SNP) Medicare Part D formulary and Medicaid List of Covered Drugs. Formulary Use the...
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General Plan Information
https://www.caresource.com/plans/marketplace/plan-documents/general-plan-information/...(3) consecutive months following your missed premium payment. During this time, we shall: Continue to pay for covered services during the first month of the grace period. Hold processing covered...
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COVID-19 Information and Resources
https://www.caresource.com/providers/tools-resources/covid-19-provider-resource-center/...federal and state guidance. We will keep you informed of any changes that could affect your health care coverage. COVID-19 Public Health Emergency Guidance COVID-19 Public Health Emergency Guidance Health...
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Archived Administrative Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/administrative-policies/archived/...Medical Necessity Determinations Medical Necessity for Medical Benefit Medications Medical Necessity for Non-Formulary / Non-Preferred Medications Medical Necessity for Non-Formulary Medications Medical Necessity for Non-Formulary Medications Medical Necessity for Non-Formulary...
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Health Care Links
https://www.caresource.com/providers/education/patient-care/health-care-links/...Medicine, 2006-(Present) National Library of Medicine Maternal Mortality Reproductive Health, Maternal Mortality Centers for Disease Control and Prevention MedlinePlus® U.S. National Library of Medicine site U.S. National Library of Medicine...
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FAQs
https://www.caresource.com/members/education/faqs/...(TTY: 711), open Monday through Friday 7 a.m. to 7 p.m. Covered Services What doctors and hospitals are covered by CareSource? You can find a list of providers that are...
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Medical Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/medical-policies/...policies apply to our Ohio Medicaid plan. These medical policies apply to our Georgia Medicaid plans. These medical policies apply to our Indiana Medicaid plans. These medical polices apply to...
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Provider Disputes or Appeals
https://www.caresource.com/providers/provider-portal/appeals/...services that are denied for reasons other than lack of medical necessity (i.e. the service is not covered by Medicaid) are not subject to external medical review. The external medical...
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FAQs
https://www.caresource.com/providers/education/faqs/...becomes primary and must be exhausted before seeking reimbursement from Medicaid or Medicare Managed Care Plans. How do I know if a member has other coverage? It is the responsibility...
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Plan Documents
https://www.caresource.com/plans/marketplace/plan-documents/...Heart Silver: offers preferred coverage for heart health medications, supplies and care. This plan has special coverage and programs for people with heart conditions, like $0 cost heart medications and...
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