...we will charge a fair, cost-based fee. Get a copy of this privacy notice You can ask for a paper copy of this notice at any time. You can ask...

...for a paper copy of this notice at any time. You can ask even if you have agreed to get the notice electronically. We will give you a paper copy...

...mail the application. Ask for a paper application by mail. You can also apply by calling DFR at 1-800-403-0864. Call today to get started. Visit www.in.gov/fssa/dfr/snap-food-assistance to learn more about...

...your secure My.CareSource.com member portal account. Click on the Health tab. Mail: You can fill out a paper copy that you get in the mail. CareSource Care Manager: Members can...

...Please visit the ESI Pharmacy Portal for claims information, including: Payer sheet Compound prescription requirements Prospective DUR response requirements Paper claim submission requirements can be found here. For questions regarding...

...blank piece of paper and take that to your provider. Helpful Links Preventive Care Chart: Pick your plan and state to see recommended preventive care*. If you have diabetes, download...

...status. CareSource accepts claims in a variety of formats, including online and paper claims. Submit Claims Online Providers have the option to submit claims through our secure, online Provider Portal*....

...a free service to our members. How can I get information sent to me in paper form? You can request information be sent to you in paper form. This is...

...plan. Visit the Forms page to find any form when you need it. How can I get information sent to me in paper form? You can request information be sent...

Administrative Law Hearing Not happy with an internal appeal decision? You may ask for an Administrative Law Hearing. This is the next formal step. It involves you or your representative,...