...fraud, waste and abuse. If you have any questions about these examples or Fraud, Waste and Abuse in general, please send an email to: Fraud@CareSource.com. Provider: Billing for non-covered, medically...

...ask how care is reviewed. You can ask about: Preservice review Urgent concurrent review Post service review Filing an appeal We do not reward providers or our staff for denying...

...can help! We can get you sign language interpreters or interpreters in the language you speak. They can help you talk with us or your providers. You can also get...

...printed version that is mailed also has your beneficiary ID card. Provider Directory The most up-to-date list of providers is available through our Find a Doctor tool (Florida | Georgia)....

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...

...is the best care for your needs. The UM department performs activities such as: prior authorization (PA), pre-service review, expedited review, post-service review, discharge planning and other utilization activities. If...

...providers, and employees. Read More Jennifer Dougherty Chief Human Resources Officer As the Human Resources leader at CareSource, Jennifer Dougherty establishes human capital strategies and capabilities for the organization. In...

...to purchase health and wellness items, redeemed for gift cards and used for online shopping (activities and redemption options vary by age, gender and health condition of member). Our providers...

...at fssabenefits.in.gov to complete your renewal online. By Mail. Fill out the renewal forms. Please include any additional information the state has asked for. In Person. Visit your local Division...

...health plans, health care clearinghouses, and health care providers who conduct the standard health care transactions electronically. Compliance with the Privacy Rule was required as of April 14, 2003 (April...