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FAQs
https://www.caresource.com/members/education/faqs/...Covered Services What kind of services are offered through CareSource Life Services® program? One of the services offered is job and career help. You can get personal life coaching, help...
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FAQs
https://www.caresource.com/providers/education/faqs/...is important to verify member eligibility before providing services. Patients must be eligible CareSource® members at the time of service in order for services to be covered. CareSource offers several...
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Claim Rejection Notifications
https://www.caresource.com/providers/provider-portal/claims/claim-rejection-notifications/...code is not a valid ICD-10 code. How to Fix: Correct Date of Service with date after ICD-10 was available. Error Number: 766 LOB: All Error Description: Services were performed...
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Archived Reimbursement Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/reimbursement-policies/archived/...Out-of-Network Providers Policy for Medically Necessary Services P Preventive Services and Sick Visit on Same Date of Service Preventive Services and Sick Visit on Same Date of Service # A...
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How and When to File an Appeal
https://www.caresource.com/members/tools-resources/grievance-appeal/file-appeal/...Denial of service Denial, termination, or reduction on a service that was previously approved Not giving a timely service or timely appeal answer. CareSource not acting in the right time...
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Primary Care Provider Roles & Responsibility
https://www.caresource.com/providers/education/patient-care/pcp-roles-responsibilities/...implement culturally and linguistically appropriate services. CLAS consists of 15 standards that encompass the following topic areas: Principal Standard: provision of effective, equitable, understandable, and respectful quality care and services...
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Where To Get Care
https://www.caresource.com/members/tools-resources/where-to-get-care/...at centers like these. Learn more about outpatient centers and ASCs. Emergency Services Emergency services are services for a medical problem that you think is so serious that it must...
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Utilization Management
https://www.caresource.com/providers/education/patient-care/utilization-management/...to submit a request for any additional services for review of medical necessity outside these dates of service prior to transition. Yes, CareSource will need to be contacted via phone...
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Gold Plans
https://www.caresource.com/plans/marketplace/plan-documents/gold-plans/...3000 $10 $0 Chronic Care Services Diabetes Gold HMO 3000 $10 $0 Chronic Care Services and Adult Vision and Fitness Healthy Heart Gold HMO 3000 $10 $0 Chronic Care Services...
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Grievance and Appeal
https://www.caresource.com/members/tools-resources/grievance-appeal/...not satisfied with the quality of care you received. CareSource denies a service. CareSource gives partial approval to cover a service. CareSource denies payment of a service. You get a...
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