...claims (CMS-1500) and hospital/facility claims (UB-04) electronically. CareSource’s dental claims are managed through SkyGen, which accepts electronic dental claims through clearinghouses and the SkyGen Portal. We recommend that dental health...

...27699-1201 Phone: 1-855-408-1212 Fax: 919-807-6865 https://www.ncdoi.gov/consumers/health-insurance/health-claim-denied/request-external-review To request an expedited review for urgent circumstances, select the “Request for Expedited Review” option in the External Review Request Form. Out-of-Network Liability and...

...is a national voluntary health agency to help reduce disability and death from cardiovascular diseases and stroke. Dental Health ADA® Center for Evidence-Based Dentistry™ Clinical Practice Guidelines The American Dental...

...year. This is true even if you feel healthy. Bone Density Exam: If you are over the age of 65, you should get at least one bone density exam. This...

These pharmacy policies apply to the TRICARE Prime® Demo by CareSource Military & Veterans™ plan. These pharmacy policies apply to our Georgia Medicaid plan(s). Pharmacy policies offer guidance on determination...

...Pharmacy Termination Disclosure 12/02/2025 Transition of DentaQuest and SkyGen to Delta Dental 12/01/2025 Telehealth and Remote Patient Monitoring 12/01/2025 Important Reminder: Coordination of Benefits 11/03/2025 ODM Next Generation MyCare Program...

...and co-occurring medical issues. Care & Disease Management Learn how our care and disease management programs can help those suffering from complex health conditions. Dental Access dental resources and dental...

...CareSource provides the opportunity for providers to discuss the utilization management (UM) medical necessity determination of a denial or decrease in level of care with CareSource’s Medical Director/Behavioral Health Medical...

...Denial of service Denial, termination, or reduction on a service that was previously approved Not giving a timely service or timely appeal answer. CareSource not acting in the right time...

...you received. CareSource denies a service. CareSource gives partial approval to cover a service. CareSource denies payment of a service. You get a surprise bill from your provider. What is...