...metrics such as: HEDIS CAHPS Provider satisfaction survey results Health Outcomes Survey Over and underutilization patterns and trends On an annual basis, we formally evaluate our QI program and performance...

...Determination Online: Complete the Coverage Determination Request Form online. Call: Member Services Fax or Mail: Download the Coverage Determination Request Form and fax or mail it to us. Fax: 1-877-251-5896...

...supplies and enteral formula face masks, hand sanitizer and patient gowns Your doctor can help you get the equipment if you need it. Important phone numbers In case of an...

...HIV/AIDS. Tobacco, in all forms, also causes many other health issues. These issues can be: Heart disease. Cancer Breathing problems. Dental problems. Eye and ear problems. Bone problems. Reproductive problems....

...Maintenance Form (PMF) during the DOS. The provider’s affiliation status will need to be reviewed with ODM, and once updated on the PMF, the claim can be resubmitted. Claims submitted...

...news you can use. Forms We want you to easily find the forms you need for your CareSource plan. Visit the Forms page to find any form when you need...

...and Children (WIC) Program can help. Formula Feeding The nutritional needs of babies are very specific in their first year of life. No brand of infant formula is best for...

f Clinical Practice Guidelines CareSource approves and adopts evidence-based nationally accepted standards and clinical practice guidelines to help inform and guide the provision of clinical care to members. CPGs are...

...a Prescription Drug Formulary (or just Formulary). Your Formulary is a list of cost-effective drugs that you might use. Usually drugs and devices on the Formulary are covered for you,...

...for your needs that is on the formulary. You can also see if a drug is on the formulary and what it may cost by checking the Find My Prescriptions...