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Medicaid with MyCare Ohio
https://www.caresource.com/plans/mycare/benefits-services/medicaid-with-mycare-oh/...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...
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Medicare and Medicaid with MyCare Ohio
https://www.caresource.com/plans/mycare/benefits-services/medicare-medicaid/...(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...
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Medication Therapy Management
https://www.caresource.com/members/tools-resources/find-my-prescriptions/medication-therapy-management/...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...
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Grievance and Appeal
https://www.caresource.com/members/tools-resources/grievance-appeal/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...
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File a Grievance
https://www.caresource.com/members/tools-resources/grievance-appeal/file-grievance/...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...
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Larry Smart, Chief Financial Officer
https://www.caresource.com/about-us/executive-leadership/larry-smart-chief-financial-officer/...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...
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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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Fraud, Waste & Abuse
https://www.caresource.com/providers/education/fraud-waste-abuse/...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...
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Get Credentialed
https://www.caresource.com/providers/education/become-caresource-provider/get-credentialed/...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...
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Sanjoy Musunuri, Executive Vice President, Strategy and Business Development
https://www.caresource.com/about-us/executive-leadership/sanjoy-musunuri-executive-vice-president-strategy-and-business-development/...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...
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