...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...

...submit a request for a prior authorization using this form. A list of services that require Prior Authorization is available on the Plan Documents page. We want you to easily...

...may not bill members for any covered services. To charge the member for non-covered services, the provider must obtain written acknowledgement that the member is assuming financial responsibility prior to...

...on when a prior authorization is required. You can also review our prior authorization list. Supplemental Benefits For 2026, CareSource Marketplace Plans feature the following supplemental benefits: TruHearing® provider network...

...and preventive services do not need prior authorization. Many of these other services do require prior authorization. Call Member Services at 1-844-607-2829 (TTY: 711) to learn more. Dental Cleanings Yes...

...scientific evidence, the guidelines will be determined by board-certified practitioners from appropriate specialties. CareSource submits to DCH for review and prior approval and as updated thereafter all clinical practice guidelines....

...a link between your office and CareSource. It provides important information on topics such as covered services, services that require prior authorization, claim submission, and more. View the Dental Provider...

...Guides CareSource is committed to primary-behavioral health integration. We prioritize seamless communication initiated by behavioral health to primary care providers to promote the best outcomes for members. Please use the...

...Changes to the Drug List Notification Date Summary of Formulary/Prior Authorization Changes Effective April 1, 2026 03/01/2026 Summary of Formulary/Prior Authorization Changes Effective January 1, 2026 12/01/2025 Summary of Formulary/Prior...

The policies below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here. # A B C D E F G H I...