...questions about a dispute to a provider disagreeing with a denial. They do not include inquiries that come through ODM’s Provider Web portal (HealthTrack). Provider disputes do include provider disagreements...

...services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing...

...Medicaid (ODM) Next Generation Program - Provider Updates for October 1 Launch 09/06/2022 Policy Updates September 2022 09/01/2022 CLIA-Waived Tests Update 08/22/2022 BH Provider Service Resolution Process Summary 08/19/2022 Provider...

...the provider portal to make any demographic changes. To do this, please log into the provider portal and click the “Provider Maintenance” option from the “Provider” menu. For further instructions,...

...CareSource PASSE to report a change within your practice. Provider Education Attestation Form Use this form to provide attestation of completing education requirements. Provider Maintenance Form Use the Provider Portal...

...the provider to have 120-day provider agreement. Providers cannot have more than one 120-day provider agreement. If a provider who is not active in ODM’s PNM system or is not...

...from your health care providers. Our providers work with us in this effort. We choose providers based on their education and quality of care. We do not discriminate against any...

...Authorization Request Form . Non-Participating Providers Prior authorization must be obtained before sending patients to nonparticipating providers, with the following exceptions. Emergency Services All in-patient services require prior authorization. Please...

...one of many services available to our providers 24 hours a day through our secure Provider Portal. The pended claims report is another resource for claim status and it is...

...HAP CareSource MI Coordinated Health Our Provider Manual is a detailed resource for working with us. Or visit our Quick Reference Materials for a variety of resources that make it...