...record. We will cover the cost of expungement up to $500 if you are eligible. You must: Not have pending charges in any state Pay all fines, fees, court costs...

...considered covered services. However, services will be covered when you receive them from an out-of-network provider connected to an in-network hospital (for example, an anesthesiologist’s services performed during a covered...

...Service Experimental and Investigational Item or Service Experimental or Investigational Item or Service Experimental or Investigational Item or Service Experimental, Investigational and Other Non-Covered Services F Fraud, Waste and Abuse...

...of multiple claims that involve the same or similar payment or coverage issues, regardless of the number of individual members or payment claims included in the bundled complaint or appeal....

...providers using guidelines from the Indiana Office of Medicaid Policy and Planning (OMPP) and the National Committee for Quality Assurance (NCQA).CareSource credentials providers using guidelines from the Indiana Health Coverage...

...We strive to limit the administrative burden while advocating for member access to quality behavioral health care. Behavioral health services are covered by HAP CareSource™ and Prepaid Inpatient Health Plans...

...Preferred Drug List (PDL) for July 1-September 30, 2022 is available here. Notification Date Posted Summary of Drug Coverage Changes Effective October 1, 2024 08/13/2024 Summary of Drug Coverage Changes...

...locations where they practice. Covered services are based on the terms and conditions described in your Certificate of Coverage. This includes medical necessity. Please call us at 1-877-514-2442 (TTY: 711)...

...plan generally must: Cover emergency services without requiring you to get approval for services in advance (prior authorization) Cover emergency services by out-of-network providers Base what you owe the provider...

...Ohio coverage area, we will offer two Medicare Advantage HMO plans and one Dual Special Needs plan in select counties in Indiana, Kentucky and Georgia for the 2021 plan year....