...through routine health plan reporting, annual Healthcare Effectiveness Data and Information Set (HEDIS®). In addition, Marketplace members complete the annual Quality Health Plan (QHP) Enrollee Survey to capture member perspectives...

...Visit our Marketplace plan pages to learn more about our plans. To easily find benefit details on the plans we offer, visit the plan documents page for the plan type...

...delivery detail of the claim, the delivery detail will be denied. Error Number: 30 Error Description: Member mismatch How to Fix: Either the member had the wrong sex identified on...

...You can use the Consent for Provider to File an Appeal on Patient/Member’s Behalf form to record this consent. Now Available: Provider Fair Hearing Plan The Provider Fair Hearing Plan...

...CareSource® Wisconsin Plans page. Click “Access Plan Documents” Schedule of Benefits (SOB) shows how you and the plan will share the cost for covered services. Summary of Benefits and Coverage...

...coverage needed to live healthy lives. For details on all HIP Plans visit our Healthy Indiana Plan page. For details on all HHW plans please visit our Hoosier Healthwise Plan...

...is not on the plan’s formulary. Asking us to waive restriction on the plan’s coverage for a drug such as limits on the amount of the drug you can get...

Review these important documents for your plan. Questions? Call us! Evidence of Coverage (EOC) The EOC gives the details for your plan including what the plan covers, how much 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 PASSE plan. You will find key...

...the care you need. You can learn more about our Access Plan by visiting www.caresource.com/WV/AccessPlan. Your Primary Care Provider (PCP) You must choose a PCP who is a network provider....