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Claim Rejection Notifications
https://www.caresource.com/providers/provider-portal/claims/claim-rejection-notifications/...at 1-800-488-0134 or visit https://www.caresource.com/providers/ for instructions. Error Number: 132 Error Description: Missing/Invalid Medicaid ID for Atypical Provider How to Fix: Ensure correct Medicaid ID is provided. Error Number: 187...
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Quality Improvement
https://www.caresource.com/providers/education/quality-improvement/...the health and safety of a member requires that medical records must be submitted under a shorter timeframe, providers are expected to comply with the shorter turnaround time. Providers and...
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General Plan Information
https://www.caresource.com/plans/marketplace/plan-documents/general-plan-information/...services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing...
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MUSCULOSKELETAL AND CARDIAC SURGICAL PROCEDURES
https://www.caresource.com/providers/tools-resources/health-partner-policies/surgical-procedures/...by calling their Provider Relations team at the number listed below, or by emailing providersupport@turningpoint-healthcare.com. Local Phone Toll Free Phone Local Fax Toll Free Fax Ohio Providers (380) 203-2125 (855)...
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Training & Events
https://www.caresource.com/providers/education/training-events/...of your choice to complete training and manage accounts for all providers in your Tax Identification Number (TIN). *Office Managers/Administrators and providers without an NPI number will need to set...
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COVID-19 Information and Resources
https://www.caresource.com/providers/tools-resources/covid-19-provider-resource-center/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...
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Fraud, Waste & Abuse
https://www.caresource.com/members/tools-resources/fraud-waste-abuse/...your email without you knowing or saying it is okay if your email is not secure. Please do not use email to send a member ID number, social security number...
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Claims
https://www.caresource.com/providers/provider-portal/claims/...providers, whether out-of-state or unenrolled providers, who are not active providers on the PNM. Providers can submit an application for screening, enrollment, and credentialing through ODM PNM & Centralized Credentialing...
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Become a Participating Provider
https://www.caresource.com/providers/education/become-caresource-provider/...number NPI number Need help? Refer to the New Health Partner Contract Form User Guide. Ready to join our network? Here’s what comes next. Start the Contracting Process Fill out...
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Provider Disputes or Appeals
https://www.caresource.com/providers/provider-portal/appeals/...External Medical Review Providers who disagree with CareSource’s determination on appeal to deny, limit, reduce, suspend, or terminate a covered service for lack of medical necessity may request an External...
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