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Claim Rejection Notifications
https://www.caresource.com/providers/provider-portal/claims/claim-rejection-notifications/...detail will be denied. Error Number: 30 Error Description: Member mismatch How to Fix: Either the member had the wrong sex identified on the claim submission, or the member’s address...
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Quality Improvement
https://www.caresource.com/providers/education/quality-improvement/...members based on their unique needs. The overarching QI program goals are aligned with the Institute for Healthcare Improvement Quadruple aim of: Improving health outcomes of members and populations Improving...
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Check Eligibility
https://www.caresource.com/providers/provider-portal/check-eligibility/...the member ID card is available in the Member ID Card Flier. Member Consent When you check eligibility on the Provider Portal, you can also determine if a member has...
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Provider Disputes or Appeals
https://www.caresource.com/providers/provider-portal/appeals/...CareSource determines, or the provider indicates in making the request on the member’s behalf or supporting the member’s request, that the standard resolution time frame could seriously jeopardize the member’s...
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Pharmacy
https://www.caresource.com/providers/education/patient-care/pharmacy/...someone to be considered for the GA LIP, please click here and provide the following information: Member’s name Member’s date of birth Member’s CareSource ID number Drug Safety Recalls Sometimes,...
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Utilization Management
https://www.caresource.com/providers/education/patient-care/utilization-management/...Members may access Member Services by calling our toll-free number, 1-833-230-2099, 7 a.m. to 7 p.m. (TTY for the hearing impaired: 1-800-743-3333) and following the menu prompts. Members may access...
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Fraud, Waste & Abuse
https://www.caresource.com/providers/education/fraud-waste-abuse/...send a member ID number, social security number or any health information. Please use the form or phone number above. This can help protect your privacy. You may also report...
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FAQs
https://www.caresource.com/members/education/faqs/...to the Member Handbook for a list of covered services. You can also ask your care coordinator or call Member Services to have a printed copy of the member handbook...
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Request Patient Services
https://www.caresource.com/providers/tools-resources/request-patient-services/...Member Services Members access Member Services by calling our toll-free number, 1-855-202-0729 (TTY for the hearing impaired: 1-800-255-0056), 7 a.m. – 7 p.m. Eastern Standard Time (EST), and following the...
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Fraud, Waste & Abuse
https://www.caresource.com/members/tools-resources/fraud-waste-abuse/...your email without you knowing or saying it is okay if your email is not secure. Please do not use email to send a member ID number, social security number...
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