...an Appeal? If you do not agree with the decision CareSource made, you have the right to appeal. An appeal is a request to reconsider and change the decision made...

...designated agents may request authorization by one of the following mechanisms: Online submission (coming soon) Form for office use Written request via fax: 1-877-251-5896 for oral medications and injectable/specialty medications...

...form. Disputes & Appeals Forms Appointment of Representative to File an Appeal on Patient/Member's Behalf Submit this form to request an appeal on behalf of a member. Expedited Appeal Form...

...can also make a complaint, file an appeal or tell us if you have other insurance besides CareSource. Member Claim Form: Use this form to request a reimbursement if you...

...45401 Disease Management 1-844-438-9498 Care Management 1-855-202-0729 Referral fax: 844-417-6255 Behavioral Health 1-855-202-1058 Quality Improvement 1-855-202-1058 Appeals 1-855-202-1058 Fax: 1-937-531-2398 CareSource Attn: Health Partner Appeals-Georgia, P.O. Box 2008 Dayton OH...

...condoms. You will need to get your prescription drugs at a pharmacy that takes CareSource. Your pharmacy benefits are provided by Gainwell. Gainwell covers all Medicaid-covered medically necessary prescription and...

...Find A Doctor online tool. Find pharmacies and covered medications with the Price a Medication/Find My Prescriptions tool. Learn about your benefits and how to get started using your plan...

...their prescription opioid medications, or other medications that are frequently abused. This program is called a Drug Management Program (DMP). If a member uses opioid medications that they get from...

...timeframe a member and/or provider has to appeal. To initiate the peer-to-peer process, please call CareSource’s Utilization Management team at 1-833-230-2101. CareSource® evaluates prior authorization requests based on medical necessity,...

...and address the most significant areas of care. Potential quality measures include the following: Antidepressant medication management Behavioral health Chronic disease management Comprehensive diabetes care Controlling high blood pressure Follow-up...