...setting and get care. This care could be for mental health and/or substance use needs. This is not a complete list of benefits. See your member handbook or call Member...

...is the best care for your needs. The UM department performs activities such as: prior authorization (PA), pre-service review, expedited review, post-service review, discharge planning and other utilization activities. If...

...comprehensive member-centric models of care to address the full population’s health and social needs. With locally based provider services, we focus on our provider relationships and customer care. For more...

...best for your needs. Learn more about Utilization Management/Service Determination in your member handbook. You can also call Member Services to get a printed copy of the member handbook sent...

...Medicaid Managed Care program. Stage 1 Implemented: On July 1, 2022, OhioRISE began providing specialized services, which will help children and youth with behavioral health needs and help those that...

...to complete. It is based on your child’s needs and health history How many assessments are there in total? There are three assessments: the first assessment and an assessment during...

...your child, if needed. The coaching calls can be tailored based on your family’s needs. What happens after each call? At the end of each call, the wellness coach will...

As Executive Vice President and Chief Medical Officer, Dr. David Williams leads and executes CareSource’s clinical vision and strategy to ensure member needs are met across the full continuum of...

...health and/or substance use needs. If You Need Counseling We want you to get the help you need. You do not need a referral from your provider to get counseling....

Respite means to take a break from the daily efforts of caring for someone with special needs. We cover respite care (planned or on an emergency basis) that gives short-term...