...is the best care for your needs. The UM department performs activities such as: prior authorization (PA), pre-service review, expedited review, post-service review, discharge planning and other utilization activities. If...

...are open Monday through Friday, 8 a.m. to 4:30 p.m. CT. Prior Authorization CareSource PASSE may ask your provider why you need a certain type or dose of medicine. Prior...

...Claims Prior Authorization Prior Authorization View prior authorization requirements and processes. Prior Authorization Forms Forms Find important forms for doing business with CareSource. View Forms Updates & Announcements Updates &...

...of your membership and your medication is not on your new plan’s covered drug list (formulary) or coverage is limited in some way, such as prior authorization, step therapy, or...

...medical practice and are the lowest cost alternative for the member. These requirements ensure appropriate use of these medications. Drug Formulary Pharmacy Policies Pharmacy Forms Prior Authorization Pharmacy Benefit Manager...

...And so much more! *Some services need to be approved before you can get them. This is called prior authorization (pre-authorization). It must be medically necessary for your care. Your...

...pregnancy. Michigan’s We Treat Hep C Initiative increases access to necessary medications such as MAVYRET for Medicaid beneficiaries by removing the prior authorization requirements and dispensing the medication in an...

...the process of moving from a child/family-centered health care model to an adult/patient-centered model, starting prior to the age of 14 and continuing into young adulthood for CSHCS enrollees. The...

...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...

...Other Types of Care You may need partial hospitalization, Intensive Outpatient Treatment and other special outpatient care, home-based care and more. You will need prior authorization for this care. Your...