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Health Care Links
https://www.caresource.com/providers/education/patient-care/health-care-links/...Prevention of Cardiovascular Disease: Executive Summary American College of Cardiology and American Heart Association Task Force on Clinical Practice Guidelines The American Heart Association is a national voluntary health agency...
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MUSCULOSKELETAL AND CARDIAC SURGICAL PROCEDURES
https://www.caresource.com/providers/tools-resources/health-partner-policies/surgical-procedures/...Spinal Cord Neurostimulator Spinal Decompression Thermal Intradiscal Procedures Cardiac | Including all associated partial, total, and revision surgeries Cardiac Catheterization Coronary Angioplasty/Stenting Implantable Cardioverter Defibrillator ICD Revision or Removal Pacemaker...
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Quality Improvement
https://www.caresource.com/providers/education/quality-improvement/...quality issue reviews. Medical record requests are forwarded to providers via mail, e-mail or fax and may be returned to CareSource via these same mechanisms as detailed in the medical...
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FAQs
https://www.caresource.com/members/education/faqs/...Get a CareSource member ID Card, Plan Documents or Change Your Doctor How do I get a new CareSource member ID card? You can get a new member ID card...
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General Plan Information
https://www.caresource.com/plans/marketplace/plan-documents/general-plan-information/...under the plan, you should show your ID card every time you request health care services. If you do not show your ID card, your provider may fail to bill...
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Pharmacy
https://www.caresource.com/providers/education/patient-care/pharmacy/...drug that has formulary limits or restrictions when medically necessary. To determine medical necessity, CareSource MyCare Ohio will verify, through the provider’s supporting statement(s) and/or standards documented in clinical guidelines...
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Prior Authorization
https://www.caresource.com/providers/provider-portal/prior-authorization/...CareSource provides the opportunity for providers to discuss the utilization management (UM) medical necessity determination of a denial or decrease in level of care with CareSource’s Medical Director/Behavioral Health Medical...
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Check Eligibility
https://www.caresource.com/providers/provider-portal/check-eligibility/...Card The member ID card is used to identify a member; it does not guarantee eligibility or benefits coverage. Members may disenroll from CareSource and retain their previous ID card....
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Past Updates & Announcements
https://www.caresource.com/providers/tools-resources/updates-announcements/past/...Provider Training Available 07/20/2022 CareSource Live Instructor-Led Provider Training and Education Series 07/07/2022 Pharmacy Policy Updates - July 2022 07/01/2022 Quarter 3 & 4 Avalon Medical Policy Update 06/30/2022 We...
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Claims
https://www.caresource.com/providers/provider-portal/claims/...Standard bank and card issuer fees apply* Paper Checks *Payment processing fees are what you pay your bank and credit card processor for use of payment via credit card. Enrollment...
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Medical card