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Pharmacy
https://www.caresource.com/providers/education/patient-care/pharmacy/...Submission Please visit the ESI Pharmacy Portal for claims information, including: Payer sheet Compound prescription requirements Prospective DUR response requirements Paper claim submission requirements can be found here. For questions...
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Prior Authorization
https://www.caresource.com/providers/provider-portal/prior-authorization/...authorized before the service is delivered. CareSource is not able to pay claims for services in which prior authorization is required, but not obtained by the provider. 2026 Prior Authorization...
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Welcome To CareSource
https://www.caresource.com/welcome-to-caresource/Thank you for choosing us! We want you to be happy with your coverage. Use our online self-service tools anytime 24/7. You can also call Member Services when you have...
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Updates & Announcements
https://www.caresource.com/providers/tools-resources/updates-announcements/...the OAC Rule 5160-8-52 Pharmacist Services 02/10/2026 Pharmacy Policy Updates February 2026 02/06/2026 Prior Authorization Requirement Update 02/03/2026 Policy Updates February 2026 02/01/2026 Prepay Auditing Update 01/29/2026 Notice to Home...
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Claim Rejection Notifications
https://www.caresource.com/providers/provider-portal/claims/claim-rejection-notifications/...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:...
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Marketplace
https://www.caresource.com/plans/marketplace/...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....
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QEP Flu Shot - DSNP
https://www.caresource.com/providers/qepflushot-dsnp/...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...
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HIP Plus vs HIP Basic
https://www.caresource.com/plans/medicaid/hip-plus-vs-basic/...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...
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ICD-10
https://www.caresource.com/providers/education/icd-10/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....
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How to Get Help with Drug Costs
https://www.caresource.com/plans/dsnp/pharmacy/drug-cost-help/...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...
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