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The frequently asked questions below are intended to help First Tier, Downstream and Related Entities (FDR) understand and manage their compliance efforts. Please click on the expandable menus below to...

The first thing to know is that a covered service or benefit, in most cases, is not free to you. There are costs that come with most care. Knowing the...

...door. Medicare Prescription Payment Plan: Pay out-of-pocket prescription costs in monthly payments over the plan year instead of all at once at the pharmacy. List of Covered Drugs (Formulary) If...

...our services and operations. CareSource – An Industry Leader in Operational Excellence CareSource is among the best in the nation at meeting and exceeding state and federal claims payment metrics....

...readiness and retention of military families. Delivering Operational Excellence for Providers We consistently outperform industry benchmarks in key operational areas, ensuring fast, accurate claims payments and unparalleled service. Explore Military...

...at least 30 calendar days prior to the intended effective date of the change. To be protected from liability for payment of any fees that are the obligation of the...

...and exceeding state and federal claims payment metrics. Through an ongoing emphasis on getting things right the first time, CareSource ranks among industry leaders in operational efficiency. <0.5 <0.01% 96%...

An Industry Leader in Operational Excellence We are among the best in the nation at meeting and exceeding state and federal claim payment metrics. Through our ongoing emphasis on getting...

...the formulary? Yes, if you believe you are entitled to payment or benefits on a certain drug, you can request a coverage determination. A coverage determination is a decision made...