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Appeals
https://www.caresource.com/members/tools-resources/grievance-appeal/appeal/...Part B drug appeals may not be extended. Learn more about appeals in your Evidence of Coverage (EOC) or Medicaid-Only Member Handbook. Questions? Call Member Services at 1-855-475-3163 (TTY: 1-833-711-4711...
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Plan Documents
https://www.caresource.com/plans/tricare-prime-demo/plan-documents/We want you to easily find the documents you need. The list below also tells you when and why you may need to use one of these documents. Beneficiary Handbook...
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Quality Improvement
https://www.caresource.com/members/tools-resources/quality-improvement/Select your plan from the drop down list above, then click GO. We want you to be happy with the care and services you get. We monitor some areas of...
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File a Grievance
https://www.caresource.com/members/tools-resources/grievance-appeal/file-grievance/...of health care services Claims, payments, handling or reimbursement for health care services Matters involving the contractual relationship between the member and the plan These types of grievances do not...
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Subrogation and Records Request Information
https://www.caresource.com/about-us/legal/subrogation-and-records-request-information/Subrogation The Rawlings Company handles all CareSource subrogation and workers’ compensation recovery matters, except Ohio Medicaid claims. Please direct all inquiries to: The Rawlings Company PO Box 2000 LaGrange, KY...
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Utilization Management/Service Determination
https://www.caresource.com/plans/caresource-passe/benefits/utilization-management/...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...
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HIPAA Privacy Practices - North Carolina Marketplace
https://www.caresource.com/about-us/legal/hipaa-privacy-practices/hipaa-privacy-practices-north-carolina-marketplace/...health. This information is shared to handle your care and treatment or to help with benefits. This information is shared with your past, current, and future treating providers. It is...
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HIPAA PRIVACY PRACTICES
https://www.caresource.com/about-mstc/legal/hipaa-privacy-practices/...that are a danger to your health. This information is shared to handle your care and treatment or to help with benefits. This information is shared with your past, current,...
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Benefits & Services
https://www.caresource.com/plans/georgia-pathways-to-coverage/benefits-services/...Member Handbook. Services Not Covered CareSource will not pay for the following services that are not covered by Medicaid: Abortions except in the case of a reported rape, incest or...
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Advance Directive
https://www.caresource.com/members/education/planning-ahead/advance-directive/...can make health care choices for you if you are not able. You can learn more about Advance Directives in your member handbook. Plan Ahead It will help you, your...
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