...our members: Behavioral Health Find behavioral health resources for patients with mental health, substance use and co-occurring medical issues. Behavioral Health Carve-In Get support during the transition to Behavioral Health...

These medical policies apply to the CareSource plan. Medical policies offer guidance on determination of medical necessity and appropriateness of care for approved benefits. Benefit determinations and coverage decisions are...

...may be subject to limitations and/or qualifications. Payment will be determined based upon a review of the actual services provided to a member and will be determined when the claim...

...(Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. CareSource, Inc. is a not-for-profit, 501(c)(3) entity. Its...

...Benefit Determination A decision we make about your coverage or benefits is called a benefit determination. If you believe a decision we have made adversely affects you, you have a...

...VaxCare LARC Inventory Platform 04/12/2022 BH OAHP Readmission Policy 04/12/2022 Billing Updates: Duplicate Discharge Day Management/ICD-10 7th Character and Therapy Proposal 04/01/2022 Benefits of School-Based Health Centers for Ohio Students...

...Lists Georgia Medicaid and PeachCare for Kids® Planning for Healthy Babies® (P4HB) Family Planning P4HB Inter-Pregnancy Care (IPC) Over-The-Counter (OTC) Product List Find My Prescriptions Do you want to look...

...strength of your bones. If you are between 50 and 65, talk with your provider to see if you need a bone density test. Breast Cancer Screen: Women between the...

Our Commitment We are committed to improving our beneficiaries’ health by removing barriers to care and working with our community partners and providers to drive meaningful change. Provider Responsibilities Providers...

...(EDI): The EDI serves as the central hub for all claims-related activities, providing transparency and visibility into care and services. The EDI transaction process has been modernized as part of...