...evaluates the quality of health care that health plans provide to their members and how well a health plan manages all parts of its delivery system — physicians, hospitals, other...

...health outcomes are monitored through routine health plan reporting, annual Healthcare Effectiveness Data and Information Set (HEDIS®). In addition, Marketplace members complete the annual Quality Health Plan (QHP) Enrollee Survey...

...up to 14 calendar days, if the extension is in the member’s best interest. The plan will make reasonable efforts to provide the member with prompt oral notification of the...

...a participating health partner? Providers can visit our Plan Participation page to learn how to contract with CareSource. Or, call Health Partner Services at 1-855-202-1058. We can give you the...

...CareSource? If you disenroll from CareSource or enroll in a new plan with drug coverage, your participation in this payment option will end. You will continue to receive a monthly...

CareSource® offers care coordination that can provide a broad spectrum of educational and follow-up services for your patients. You can access care plans online through the provider portal to easily...

...business Corrective action of any identified fraud, waste and/or abuse are available in the provider manual. For provider terminations/suspensions information, see the CareSource Fair Hearing Plan (coming soon). Prohibited Affiliations...

...Carolina Co.® wants to equip you to work with our health plan to provide the best service for our members. These materials will help familiarize you with our Marketplace plans....

...new plan with drug coverage, your participation in this payment option will end. You will continue to receive a monthly invoice for the amount owed until your balance is paid...

...covered under a benefit plan. The prior authorization staff will adhere to the CareSource MyCare Ohio Centers for Medicare & Medicaid Services (CMS) approved criteria. The PBM’s National Pharmacy and...