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Your HDHP Preventive Plan
https://www.caresource.com/plans/marketplace/plan-documents/your-hdhp-preventive-silver-plan/...Ask your provider to ‘e-prescribe’ a 3-month supply to Express Scripts. Your provider should already have the website and phone number. Plan Costs Learn more about your plan’s costs by...
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Dental
https://www.caresource.com/providers/education/patient-care/dental/CareSource’s covered routine dental benefits are administered by Delta Dental. Delta Dental Phone: 1-833-778-7003 Routine Dental Providers Please use the Providers Dental Provider Login menu option of the Provider Portal...
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Contact Us
https://www.caresource.com/members/contact-us/...you have questions about your health, our nurse advice line provides around-the-clock access to a caring and experienced staff of registered nurses. Members can call the toll-free number located on...
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Medical Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/medical-policies/...providers are solely responsible for diagnosis, treatment and medical advice. CareSource is not responsible for, does not provide, and does not represent itself as a provider of medical care. Policies...
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Administrative Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/administrative-policies/...Management Providers Pharmacogenomics-Gene Testing for Behavioral Health Indications Policy Development Process Program Integrity Provider Prepayment Review R Readmission Retrospective Authorization Review S Sentinel Events and Provider Preventable Conditions Serum Biomarker...
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Grievance and Appeal
https://www.caresource.com/members/tools-resources/grievance-appeal/...the care provided. If you are unhappy or don’t agree with a decision made by CareSource or our providers, you or your authorized representative can let us know. In order...
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Quality Improvement Program
https://www.caresource.com/members/tools-resources/quality-improvement/qip/...and safety of clinical care and services provided to CareSource members There are two guiding principles for the program: Our mission, which is our heartbeat, is to make a lasting...
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Fraud, Waste & Abuse
https://www.caresource.com/members/tools-resources/fraud-waste-abuse/Our Program Integrity Department handles cases of managed care fraud, waste or abuse. It can be done by providers, pharmacies, or members. Fraud means the purposeful misuse of or for...
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Tools & Resources
https://www.caresource.com/providers/tools-resources/...More Forms Forms Find forms for contracting, authorization, claim submission and more. View Forms Provider Policies Provider Policies View medical, reimbursement, pharmacy and administrative provider policies. Review Policies Quick Reference...
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False Claims Act
https://www.caresource.com/providers/education/fraud-waste-abuse/false-claims-act/As an entity that offers Medicaid and Medicare coverage, CareSource® is required to comply with certain provisions of the Deficit Reduction Act. One such provision requires us to provide you...
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