...payer claim adjustment group codes as reported on the 835 payment or as identified on the EOP, such as deductible, coinsurance, copayment, contractual obligations and/or non-covered service group codes. Adjustment...

...also be used to designate a person to speak on the member’s behalf. This designated representative can be a relative, a friend, a physician, an attorney or some other person...

...• Help your providers and other caregivers work better together • Help you learn about your drugs and the right way to use them • Help your overall health You...

...enrollment period, CareSource can help. We’ve been helping our members through uncertain times for over 30 years. CARESOURCE MARKETPLACE PLANS COVER ESSENTIAL HEALTH BENEFITS Preventive & wellness services Emergency services...

...it easier for you to help our members access the care they need. Access the valuable tools and resources linked on this page to help us best serve our members....

...Submitting Ohio Medicaid Provider Number Applications 11/17/2017 Enhanced Ambulatory Patient Groups (EAPG) Billing Methodology Supersedes CareSource Payment Policies 11/07/2017 December 2017 Policy Release 11/01/2017 Diagnosis Related Group Rate Changes 10/24/2017...

...The Office of the Inspector General (OIG) has free educational materials to help providers learn about federal laws designed to protect Medicaid and Medicare programs and program beneficiaries from fraud,...

...Policies Provider Policies View medical, reimbursement, pharmacy and administrative provider policies. Review Policies Quick Reference Guides Quick Reference Guides Access key information to help you work with us. View The...

...be your PCP, it helps us to make sure that your visits are billed at the PCP cost. Going to the same PCP each time you need care will help...

...When you report fraud, waste or abuse, please give us detailed information that includes a clear description of what you believe has happened. Please also give us the names and...