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Care Coordination
https://www.caresource.com/providers/education/patient-care/care-coordination/...community resources such as family service agencies, court systems, local mental health agencies, food banks, schools, pharmacies, primary care doctors and other appropriate paid and non-paid resources. We stress the...
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Care & Disease Management
https://www.caresource.com/members/education/care-disease-management/...Kidney Disease Congestive Heart Disease Diabetes Perinatal Conditions Prediabetes Pregnancy Obesity Organ Transplants Serious and persistent behavioral conditions Substance Use Disorder If your doctor, pharmacy or other health care provider...
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Health Care Terms
https://www.caresource.com/plans/dsnp/benefits-services/behavioral-health/health-care-terms/...may be offered if you were recently in the hospital. It includes one-on-one and group therapy. Treatment happens during the day. You do not have to stay overnight. Pharmacological Counseling...
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Next Generation Managed Care
https://www.caresource.com/providers/tools-resources/next-generation-managed-care/...System (OMES) Provider Network Management (PNM) module, which will reduce administrative burden on providers. Also, the Single Pharmacy Benefit Manager (SPBM) will begin providing pharmacy services across all managed care...
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Medication Disposal
https://www.caresource.com/members/tools-resources/find-my-prescriptions/medication-disposal/...to the DEA site to see a list of sites near you. RETURN TO THE PHARMACY OVERVIEW Do you have any old or unused medications? Don’t just throw them away...
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Benefits & Services
https://www.caresource.com/plans/tricare-prime-demo/benefits-services/...every two years. Dental Care If you get your dental benefits through TRICARE, they are provided through United Concordia. Call 844-653-4060 to learn more. Pharmacy Your pharmacy benefits are provided...
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Comprehensive Formulary
https://www.caresource.com/plans/dsnp/pharmacy/drug-formulary/...Pharmacy Overview The comprehensive formulary is a list of drugs covered under the Part D benefit of your CareSource plan. 2026 Comprehensive Formulary CareSource Dual Advantage (Last updated on 04/01/2026)...
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Claims
https://www.caresource.com/providers/provider-portal/claims/...the responsible Managed Care Organization (MCO) for processing and payment. Prior Authorization Requests: OMES will serve as the centralized location for prior authorization requests for all medical (non-pharmacy) services, standardizing...
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Provider Manual
https://www.caresource.com/providers/tools-resources/provider-manual/Our Provider Manual is a resource for working with our health plan. This manual communicates policies and programs and outlines key information, such as claim submission, and reimbursement processes, authorizations,...
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End or Change Membership
https://www.caresource.com/members/tools-resources/grievance-appeal/change-plans/If you are not happy with CareSource, let us know. We want to make it right. You have the right to change to a different Georgia Families® Georgia Pathways to...
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