...clinical practice guidelines to help inform and guide the provision of clinical care to members. CPGs are identified through member review of member population demographics and state/national priorities. Review occurs...

...Demo. Utilization Management – View our utilization management activities including prior authorization, concurrent review, discharge planning and other activities. Tobacco and Vaping Cessation Tool Kit – Access our tools and...

...(prior authorization) in order for it to be covered by your plan. The health partner who orders the drug should help you get a prior authorization. The prior authorization requirements...

...every month? CareSource PASSE care coordinators are here to help you and your family. Your health and wellness is our top priority. We will work with you, your family, caregivers...

...Check Eligibility Prior Authorization Prior Authorization View prior authorization requirements and submit authorization requests. View or Submit Update Practice Information Update Practice Information Alert us to changes in your practice....

The Public Health Emergency (PHE) for COVID-19 has ended. Services like vaccines, treatment, and testing are still available. Some rules changed, stopped, or started again. CareSource continues to watch COVID-19...

...scheduled. If you have questions about the prior authorization process or status, please call Member Services. Your provider can submit a request for a prior authorization using the Prior Authorization...

...needs and taking appropriate action Providing phone coverage for handling patients’ calls 24/7 Following all referral and prior authorization policies and procedures as outlined in the Provider Manual Complying with...

...receipt of a pharmacy prior authorization request. If it is an emergency, a 72-hour override may be used so that you can get your medicine. Prior authorization requests for a...

...planning or emergency services, out-of-network health care providers need prior authorization (also called pre-approval). Go to www.caresource.com/in/plans/medicaid/benefits-services/referrals-prior-authorization/ for more details on prior authorization. Office Visits / Hospital Type of Service...