...Medication List and Medication Action Plan by mail. Quarterly targeted medication reviews. Follow-up steps as necessary. Who Can Be in the Program? CareSource members who have chronic health conditions and...

...pages may not be inclusive of all applicable provider policies. Some benefit management services are provided on behalf of CareSource. Please reference applicable lab policies and musculoskeletal and cardiac surgical...

...or billing administrator and complete all required COB information. For professional claims (CMS-1500), COB information should be sent at the line level. For hospital/facility claims (UB-04), COB information should be...

...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...

...first before CareSource will cover it. This is called Step Therapy. Some medicines require permission (prior authorization) in order for it to be covered by your plan. The health partner...

...plan providing standard coverage with no copays and select services. BENEFIT HIGHLIGHTS BENEFIT HIGHLIGHTS All standard Medicare and Medicaid benefits All standard Medicaid benefits No Copays for Medicaid-covered drugs Waiver...

...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...

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...

...routine basis even if you are healthy. It helps them find and treat problems early before they get worse. Check out the chart of recommended preventive care based on your...