...not pay for a covered service performed by the provider unless CareSource PASSE denies prior authorization of the service and the provider notifies the member in writing that the member...

...information (SHI). The Member Consent/HIPAA Authorization Form can also be used to designate a person to speak on the member’s behalf. Please encourage CareSource members who have not consented to...

gEarn rewards for keeping your patients healthy! Flu shots can keep people healthy and out of the hospital. With so many misconceptions surrounding the flu shot, we need your help...

CareSource PASSE™ follows Arkansas Medicaid’s evidence-based Prescription Drug Program, Preferred Drug List (PDL) and Prior Authorization Criteria. Search Tips: To access the downloadable Preferred Drug List and Prior Authorization Criteria...

...which services need a prior authorization before you can get them. 2022 Prior Authorization List (Updated 10/01/2021) Usually your primary care provider (PCP) will ask for prior authorization from us...

...the Center for Medicare & Medicaid Services (CMS)-issued Children’s Health Insurance Program Reauthorization Act (CHIPRA) Core Set and the Adult Core Set of Quality Measures technical specifications along with the...

...2025 Prior Authorization List Usually your provider will ask for prior authorization from us and then schedule these services for you. Your provider can submit a request for a prior...

...the autism spectrum; prior authorization is required Counseling Individual, family and group sessions to talk it out; no prior authorization. Detoxification Treatment to help with your dependence on alcohol/drugs; prior...

...them. This process is called a Prior Authorization Request. Prior authorization may be required when: A drug has step therapy, which means you must try certain drugs before another drug...

...for claims, prior authorizations, and other administrative tasks for providers. Submitting Claims and Authorizations ODM is implementing a One Front Door approach to streamline claim and prior authorization submissions. Providers...