Want to choose or change your Primary Care Provider (PCP)? It’s easy! You can pick a new primary provider by logging into your My CareSource account. Click the Find a...

...services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing...

...the member’s card? Yes! Any participating primary care provider (PCP) may see eligible CareSource members. PCPs are responsible for verifying member eligibility before providing any services. Please log on to...

...Go to https://www.healthplanresources.com to sign in using your NPI* and use the password provided in your Welcome Letter. Office Managers/Administrators: Managing a group of providers? Sign in through the Provider...

...Medicaid (ODM) Next Generation Program - Provider Updates for October 1 Launch 09/06/2022 Policy Updates September 2022 09/01/2022 CLIA-Waived Tests Update 08/22/2022 BH Provider Service Resolution Process Summary 08/19/2022 Provider...

...(CAHPS®) performance Comprehensive population health management program Comprehensive provider engagement program NCQA Health Plan Rating of 5 High level of HEDIS performance Comprehensive population health management program Comprehensive provider engagement...

...Provider Types To qualify as a PCP, a provider must practice in one of the following primary care areas: General practice Family practice Internal medicine Pediatrics Obstetrics/gynecology A specialist may...

...providers, whether out-of-state or unenrolled providers, who are not active providers on the PNM. Providers can submit an application for screening, enrollment, and credentialing through ODM PNM & Centralized Credentialing...

...and providers to get you care. We call these in-network providers. To have your health care services covered by your CareSource plan, you must go to an in-network provider. Use...

...Health Contact Us If you are not finding the information you need or have more questions, please call us. Our Provider Services staff is happy to assist you. CONTACT US...