f Clinical Practice Guidelines CareSource approves and adopts evidence-based nationally accepted standards and clinical practice guidelines to help inform and guide the provision of clinical care to members. CPGs are...

...Management department. Please call 1-833-230-2101 for any questions related to post-stabilization services. Advanced Imaging Prior Authorization Ordering physicians must obtain prior authorization for the following outpatient, non-emergent diagnostic imaging procedures:...

...and abuse situations. From the Office of the Inspector General The Office of the Inspector General (OIG) has created free educational materials to assist in teaching physicians about the federal...

...a physician’s medical judgment about individual patients. CareSource of North Carolina Co. defaults to all applicable state and federal guidelines regarding criteria for authorization of covered services. CareSource of North...

...performance of physicians and other health care practitioners. Providers are recredentialed a minimum of every three years and are considered to be recredentialed unless otherwise notified. Finish Onboarding Learn how...

Providers who wish to contract with CareSource® must first be credentialed. Through credentialing, we check the qualifications and performance of physicians and other health care practitioners. Providers are recredentialed a...

...can submit a pre-service or post-service clinical appeal. Clinical appeals are reviewed by nurses and physicians not involved in any prior review. They are also reviewed by practitioners with expertise...

...Health website for toolkits and educational resources. A free 9-credit continuing medical education (CME) course, A Physician’s Practical Guide to Culturally Competent Care, is included. All CareSource members may choose...

CareSource wants to equip you to work with our health plan to provide the best service for our members. The following materials will help familiarize you with the CareSource Ohio...

...to provide these services. CareSource members can access physicians throughout Georgia without leaving their local area. They can see physicians in over 45 specialties, in addition to primary care, trauma,...