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Utilization Management
https://www.caresource.com/plans/mississippi-chip/utilization-management/...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...
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CareSource Interoperability Overview
https://www.caresource.com/about-us/legal/interoperability-apis/...Use the HL7 FHIR (Fast Healthcare Interoperability Resource) for patient and publicly available provider data Use of OAuth 2.0 or Open ID for authorization flows to support for member authorization...
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OhioRISE
https://www.caresource.com/ohiorise/...role of CANS in determining OhioRISE eligibility. This flier can be distributed by CANS assessors prior to or at the time of a CANS assessment. Care Coordination Portal Access Training...
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Welcome To CareSource
https://www.caresource.com/welcome-to-caresource/Thank you for choosing us! We want you to be happy with your coverage. We offer a suite of online self-service tools, but you can always call Member Services with...
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Request Patient Services
https://www.caresource.com/providers/tools-resources/request-patient-services/We make it easy for you to request services for your patients. See below for benefit information and instructions to obtain services that enable improved access to care. 9-8-8 Suicide...
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Quick Start Guide
https://www.caresource.com/members/tools-resources/quick-start-guide/We are excited to welcome you as a CareSource member and introduce some of the programs and tools that make CareSource more than just health insurance. We are Health Care...
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How and When to File an Appeal
https://www.caresource.com/members/tools-resources/grievance-appeal/file-appeal/...you know we got your appeal. The people making appeal decisions are not part of prior reviews or decision making. They are health care professionals. They are supervised by our...
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Medical Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/medical-policies/These medical policies apply to the CareSource plan. Medical policies offer guidance on determination of medical necessity and appropriateness of care for approved benefits. Benefit determinations and coverage decisions are...
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Forms
https://www.caresource.com/arkansas/forms/Provider Attestation Form – Submit this form to attest to practice competency prior to working with CareSource. CCVS Provider Authorization and Release Form – Submit this form to authorize release...
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Next Generation MyCare
https://www.caresource.com/plans/mycare-snp/...exam, cleaning, fluoride treatments and dental implants. *Prior Authorization required. Vision Benefits No cost routine eye exam. Routine Exam, Eyeglasses are covered: Age 21-59 – 1 pair every 2 years;...
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Prior authorization