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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/...for D-SNP 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...
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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/...and/or the denied claim If filing an appeal on behalf of a member or for pre-service issues, the member’s written consent (or signed Appointment of Representative form(coming soon) for dual...
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Pharmacy
https://www.caresource.com/providers/education/patient-care/pharmacy/...response to Formulary drugs. The member or member’s representative can call Member Services to make the request or can complete the online Member Exception Request for Non-Formulary Medication. When a...
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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/...member. Get a CareSource member ID Card, Plan Documents or Change Your Doctor How do I get a new CareSource member ID card? Log into your My CareSource account to...
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Contact Us
https://www.caresource.com/members/contact-us/...members. If you have any problems reading or understanding this information, please call our Member Services team or use our TTY for hearing impaired members at the number below. This...
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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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