...a prior authorization is required for the medication. Pharmacy Claims Submission Please visit the ESI Pharmacy Portal for claims information, including: Payer sheet Compound prescription requirements Prospective DUR response requirements...

...services that require prior authorization from CareSource should be authorized before the service is delivered. CareSource is not able to pay claims for services in which prior authorization is required,...

...not by CareSource. There are two ways in which the funds are distributed: Advance Premium Tax Credit (APTC) A tax credit based on income level that lowers monthly premium payments....

...to Fix: Correct DOS with date after ICD-10 was available. Error Number: 766 Error Description: Services were performed during a Health Insurance Exchange (HIX) premium payment grace period. Error Number:...

...DSNP patients in your practice! Here’s how you can start earning these payments: STEP 1: LEARN ABOUT THE QUALITY ENHANCER PROGRAM To start earning flu shot payments, we recommend you...

...you will pay a POWER Account Contribution (PAC) each month. The amount you pay for your PAC varies by person. You can learn more about the payment tiers in the...

In 2015, the health care industry adopted the ICD-10 code set for reporting diagnoses and procedures to payers. CareSource is committed to meeting the requirements of the ICD-10 code set....

...we will update our system so that you can pay the correct copayment when you get your next prescription at the pharmacy. If you overpay on your copayment, we will...

Coverage Determinations (Decisions) A decision we make about the payment for a Part D drug or an exception to our formulary. If you believe you are entitled to payment or...

...doctor View or print your ID Card or have one mailed to you Pay your monthly premium View payments and past invoices View claims to see what CareSource paid and...