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Opioid Toolkit
https://www.caresource.com/providers/education/patient-care/behavioral-health/opioid-toolkit/...for Chronic Pain Ohio 80-Morphine Equivalent Dose (MED) State Medical Board Guidelines Ohio Guidance Prescribing Opioids to Minors 2014 Opiates: Transforming Prescribing Protocols Ohio State University (OSU) 2014 Utah Pain...
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Fraud, Waste and Abuse (FWA)
https://www.caresource.com/about-us/legal/corporate-compliance/vendor-compliance/fraud-waste-and-abuse-fwa/...Fraud (Ohio Revised Code Section 2913.40) Medicaid Eligibility Fraud (Ohio Revised Code Section 2913.401) Falsification (Ohio Revised Code Section 2921.13) Offenses by Medicaid Providers (Ohio Revised Code Section 5164.35) Kentucky...
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Provider Disputes or Appeals
https://www.caresource.com/providers/provider-portal/appeals/...within 30 calendar days of the date of the internal appeal notification. Providers must complete the “Ohio Medicaid MCE External Review Request” form located at www.hmspermedion.com (select Contract Information and...
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Primary Care Provider Roles & Responsibility
https://www.caresource.com/providers/education/patient-care/pcp-roles-responsibilities/...care from community partners. Roles and Responsibilities According to the Ohio Administrative Code (OAC) 5610-26-03.1(B), PCP care coordination responsibilities include at a minimum, the following: Assisting with coordination of the...
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File a Grievance
https://www.caresource.com/members/tools-resources/grievance-appeal/file-grievance/A grievance is a formal complaint about us, our providers or the care you get. You or an authorized representative may file a grievance at any time. Call Member Services...
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ICD-10
https://www.caresource.com/providers/education/icd-10/...other industry ICD-10 websites. New CMS-1500 Claim Form Ohio Department of Medicaid (ODM) Tips & Alerts Claims Compliance Date Span Date Billing ICD-10 and Dental Claims Billing Unspecified Codes Inpatient...
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Health Care Links
https://www.caresource.com/providers/education/patient-care/health-care-links/...Development Pregnancy: Safer Medication Use Treating for Two: Medicine and Pregnancy Centers for Disease Control and Prevention Perinatal Quality Collaborative Ohio Perinatal Quality Collaborative Behavioral Health Guidelines Health Condition Clinical...
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Past Newsletters & Communications
https://www.caresource.com/providers/education/newsletters-communications/past-communications/...ProviderSource Newsletter Summer 2018 ProviderSource Newsletter Ohio Insert Spring 2018 ProviderSource Newsletter Spring 2018 ProviderSource Newsletter Ohio Insert Spring 2018 ProviderSource Newsletter Annual Insert Winter 2017 ProviderSource Newsletter Fall 2017...
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MUSCULOSKELETAL AND CARDIAC SURGICAL PROCEDURES
https://www.caresource.com/providers/tools-resources/health-partner-policies/surgical-procedures/...Authorization & Provider Portal Portal providers and/or their delegates should follow Ohio Department of Medicaid’s (ODM) guidelines to submit prior authorization requests and supporting documentation through the Ohio Medicaid PNM...
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Tobacco Use & Chronic Disease
https://www.caresource.com/members/education/smoking-cessation/tobacco-use-chronic-disease/...can even cause new diseases that can lead to death. CareSource is here to help you stop using tobacco and offers rewards for enrolling in the Ohio Tobacco Quit Line....
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