...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...

...(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...

...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...

Let us know if you are unhappy or do not agree with a decision made by us or our providers. We want to make it right. Please call Member Services...

...part of prior reviews or decisions. Please call Member Services if you are not happy with our decision. You also have the right to file a complaint at any time...

...best-in-class achievements to support CareSource’s mission of growth. Prior to joining CareSource, Larry was recently the Senior Vice President and Chief Actuary for WellCare, where he led the actuarial and...

...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...

...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...

...will not pay for claims for dates of service prior to the credentialing approval date. Contracting Upon a provider’s interest in contracting with CareSource, the process below is followed: CareSource...

...Long-Term Services and Support (LTSS), Medicaid and Medicare. Throughout his career, he has driven successful business development strategies, created effective provider engagement initiatives and positioned markets for product expansion. Prior...