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Archived Reimbursement Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/reimbursement-policies/archived/...B Breast Imaging C CLIA-Waived Testing in Office Setting Coordination of Benefits Coordination of Benefits COVID-19 Vaccine Reimbursement COVID-19 Vaccine Reimbursement D Dental Procedures in a Hospital, Outpatient Facility or...
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Why Choosing a PCP is Important
https://www.caresource.com/members/tools-resources/why-choosing-a-pcp-is-important/...description of covered benefits, please refer to your Evidence of Coverage. Finding the Right PCP Is Important to Your Health Care Journey Establishing a relationship with your PCP can go...
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Pharmacy
https://www.caresource.com/providers/education/patient-care/pharmacy/...may request authorization by one of the following mechanisms: Online submission Form for office use English | Spanish Written request via fax: 1-877-251-5896 for oral medications and injectable/specialty medications Toll-free...
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Utilization Management
https://www.caresource.com/providers/education/patient-care/utilization-management/...Mail: CareSource of North Carolina Co. P.O. Box 1307 Dayton, OH 45401-1307 On an annual basis, CareSource of North Carolina Co. completes an assessment of satisfaction with the UM process...
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Training & Events
https://www.caresource.com/providers/education/training-events/...Go to https://www.healthplanresources.com to sign in using your NPI* and use the password provided in your Welcome Letter. Office Managers/Administrators: Managing a group of providers? Sign in through the Provider...
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Find My Prescriptions
https://www.caresource.com/members/tools-resources/find-my-prescriptions/...find a copy of the PDL on the Ohio Department of Medicaid website or on the Gainwell pharmacy website. Please call Gainwell Member Services at 1-833-491-0344 (TTY: 1-833-655-2437) if you...
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Additional Services
https://www.caresource.com/benefits-services/additional-services/The following chart is a summary of what you get when you have: MyCare Ohio (MEDICARE + MEDICAID) MyCare Ohio (Medicaid Only) This is your chance to make your health...
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Open Enrollment Deadlines
https://www.caresource.com/plans/marketplace/open-enrollment-deadlines/...and Schedule of Benefits documents at CareSource.com/Marketplace. Specific policy requirements and benefits listed on this website are provided for assistance in accessing or understanding your benefits and coverage. References to...
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Referrals & Prior Authorization
https://www.caresource.com/plans/medicaid/benefits-services/referrals-prior-authorization/...pre-approval. There may also be differences between the Healthy Indiana Plan and Hoosier Healthwise plans. More details are in the HHW and HIP Summary of Benefits sections. Questions about PA?...
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HIPAA Privacy Practices - Indiana Marketplace
https://www.caresource.com/about-us/legal/hipaa-privacy-practices/hipaa-privacy-practices-indiana-marketplace/...do this. We will give you a copy or a summary of your health and claims records. We often do this within 30 days of your request. We may charge...
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Summary of benefits