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How and When to File an Appeal
https://www.caresource.com/members/tools-resources/grievance-appeal/file-appeal/...All internal appeal requests must have: The covered person’s name and ID number as shown on the ID card The provider’s name The date of the medical service The reason...
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Welcome
https://www.caresource.com/plans/marketplace/welcome/...provider while you change to in-network providers with your new plan. Call Member Services to get this started. Get Up and Running! When You Are Coming From Another Plan (another...
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Pregnancy & Family Planning
https://www.caresource.com/members/education/pregnancy/...alcohol or use illegal drugs While You Are Pregnant You can find a network provider at findadoctor.CareSource.com. Seeing your provider on a routine basis while you are pregnant can spot...
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Six Flu Shot Facts To Know
https://www.caresource.com/members/education/preventive-care/flu-shot-facts/...year. Maybe you don’t think you need it or don’t understand the importance of it. Maybe you don’t trust it. Your primary medical provider (PMP) understands your health needs best...
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Referrals & Prior Authorization
https://www.caresource.com/plans/medicaid/benefits-services/referrals-prior-authorization/...providers in the HAP CareSource network. Network or in-network provider refers to the providers who accept HAP CareSource insurance and see patients who are covered through HAP CareSource. When you...
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Substance Use Disorder Toolkit
https://www.caresource.com/providers/education/patient-care/behavioral-health/substance-use-disorder-toolkit/CareSource understands that many members will visit their primary medical provider (PMP) first when an underlying substance use disorder (SUD) condition exists and PMPs are often the first line of...
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Find A Pharmacy
https://www.caresource.com/members/tools-resources/find-my-prescriptions/find-a-pharmacy/...monitored, and members are assigned designated providers. GA LIP members must get their medicines filled at one pharmacy and use their primary care provider for medical care. Helpful terms to...
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Benefits and Services
https://www.caresource.com/plans/marketplace/benefits-services/...Update For 2025, CareSource Marketplace Plans feature the following benefits: TruHearing® provider network for hearing services is included with all plans. EyeMed® provider network for vision services on all plans...
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Plan Documents
https://www.caresource.com/plans/medicaid/plan-documents/...Find a Doctor tool. This tool will show you: Primary care providers (PCPs) Primary dental providers (PDPs)/Dental Home Specialists Hospitals Download the machine-readable Provider Directory here (json) Member Materials Behavioral...
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Quality Improvement
https://www.caresource.com/members/tools-resources/quality-improvement/...and screenings you may need. If you have a long-term (chronic) condition, be sure to: See your PCP or other health care provider regularly. Follow the treatment plan your provider...
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