...providers in the HAP CareSource network. Network or in-network provider refers to the providers who accept HAP CareSource insurance and see patients who are covered through HAP CareSource. When you...

...insurance easier to understand and use. More benefits for YOU! Combined Medicare and Medicaid plan with extra benefits and coordination for simplified planning. Medicaid-only plan providing standard coverage with no...

How could you be sure you would receive the medical treatment you choose if you were sick or incapacitated (for example, if you are unable to speak for yourself)? You...

...Carolina Co.® Marketplace plans on the Health Insurance Marketplace. Administrative policies offer guidance on determination of medical necessity, investigation and experimental services. The policies below are in PDF format. If...

...from our delegated service providers. These medical polices apply to our CareSource North Carolina Co.® plans on the Health Insurance Marketplace. Medical policies offer guidance on determination of medical necessity...

...member eligibility. These reimbursement policies apply to our CareSource North Carolina Co.® Marketplace plans on the Health Insurance Marketplace. Reimbursement policies are designed to assist you when submitting claims to...

Need Personal Assistance? If you have any problems reading or understanding this information, please call Member Services. This is a free service. We can read the information out loud for...

Definitions CareSource provides several opportunities for you to request review of dispute or authorization denials. Actions available after a denial include: Claim Appeals A claim appeal is a written request...

...your rights under the Health Insurance Portability and Accountability Act (HIPAA)? Who must follow HIPAA? The U.S. Department of Health and Human Services Office for Civil Rights enforces HIPAA. You...

...for more information. Limitations, copayments, and restrictions may apply. Benefits and/or copayments/coinsurance may change on January 1 of each year. The Formulary, pharmacy network, and/or provider network may change at...