...know. In order for CareSource to talk to your authorized representative, you and your authorized representative must complete the HIPAA Authorization Form and send it to us via fax or...

...quality issue reviews. Medical record requests are forwarded to providers via mail, e-mail or fax and may be returned to CareSource via these same mechanisms as detailed in the medical...

...you name. Or, download this hard-copy version and mail or fax the completed form to us. Please allow up to 30 days to process the hard-copy form. IRS 1095B Information...

...Reach out to one of the three major groups to do this. Equifax Experian TransUnion Get Help The Federal Trade Commission has resources for you: What to do if you...

...up-to-date service plan for our CareSource MyCare Ohio members, please fax your service plan to 937-487-0936. This number is only for service plans and NOT claim submissions. Alternative Option: Paper...

...Member Appeals P.O. Box 1947 Dayton, OH 45401 Toll Free: 937-487-0629 (for Expedited Review) Fax: 937-487-0629 Expedited Fax: 937-531-2398 You may also use the secure online form on our Forms...

...you have questions about your rights or need help. You may also write to us at: Mail: CareSource Attn: Member Appeals P.O. Box 1947, Dayton, OH 45401 Fax: 1-844-417-6262 Email:...

...please submit your prior authorization requests through the Gainwell provider web portal (preferred route) or fax completed prior authorization forms to the number below. Toll-free: 1-833-660-2402 Fax: 866-644-6147 Prior authorization...

...receiving the Adverse Benefit Determination. Appeals can be submitted by phone, in writing or by fax or email. All internal appeal requests must have: The covered person’s name and ID...

...through the Arkansas Department of Human Services Division of Medical Services. Address: P. O. Box 1437 Slot S-418 Little Rock, AR 72203-1437 Phone: 501-682-8292 (TTY/TDD: 711) Fax: 501-682-1197 Member Services:...