...plan generally must: Cover emergency services without requiring you to get approval for services in advance (prior authorization) Cover emergency services by out-of-network providers Base what you owe the provider...

...your premium. Comply with all provisions of the policy that are outlined in the Certificate of Coverage. This includes Prior Authorization Know and confirm your benefits before receiving treatment. Show...

...information on PASSE services that are offered by CareSource PASSE that include: Covered benefits and how to get them. If any benefits have prior authorization requirements. Take part in decisions...

...company (TrueCare). Staff accept collect calls about UM issues. Staff can answer questions about the UM process. You can call us about: UM for prior authorization (pre-approval) requests Any other...

...dentist and/or prior authorization from CareSource. Your dentist will make the request on your behalf. Depending on your plan, you may have more benefits. Please contact Member Services if you...

...a exam. Make sure to ask for a Healthchek exam when you call. Some of the tests and treatment services may need prior authorization. Mothers should have prenatal exams and...

...to verify procedures and payment mechanisms are compliant. Our proactive monitoring includes prepay review edits, prior authorization monitoring, analytic performance dashboard monitoring, and verification of services. Our reactive monitoring includes...

...more. Call Member Services to ask about our list of covered medications and those that need prior authorization. Medication Therapy Management, or MTM, is a service we offer at no...

...(Periodontics)* Root Canals Routine Tooth Extractions Surgical Extractions* & Other Oral Surgery * Approval or prior authorization required. We cover routine eye exams and eyewear. If you are under the...

...Canals Routine Tooth Extractions Surgical Extractions* & Other Oral Surgery * Approval or prior authorization required. We cover routine eye exams and eyewear. If you are under the age of...