The frequently asked questions below are intended to help First Tier, Downstream and Related Entities (FDR) understand and manage their compliance efforts. Please click on the expandable menus below to...

...described below: For those members who are new or who were in the plan last year and aren’t in a long-term care (LTC) facility: We will cover a temporary supply...

...citizen A documented noncitizen who has been admitted for permanent residence A noncitizen legally admitted migrant farm worker In addition: Children must be under the age of 26. Those who...

...pay, but it can influence the amount you have to pay. If you go to a provider who charges more for services than others, the portion you have to pay...

...Frequency Who’s Eligible Rewards* Cholesterol Screening 1x/Calendar Year All members age 18 and over $15 In-Home Assessment (Signify) 1x/Calendar Year Members age 18 and over with a known health risk...

...telehealth and billed with the Place of Service Code – 02. Live-in Caregiver: A direct care worker who lives in the same household as individual receiving services. Direct care workers...

...you and your baby can earn rewards: Activity Who’s Eligible Rewards Prenatal visits (first 5) Pregnant females $15 per visit, $75 per pregnancy Postpartum visit New mothers $25 per pregnancy...

...For those members who are new or who were in the plan last year and aren’t in a long-term care (LTC) facility: We will cover a temporary supply of your...

...any other required documentation to CareSource. CMS 1500 Health Insurance Claim Form Waiver services providers who cannot log into the provider portal can use this form to submit a claim....

Earn rewards for keeping your patients healthy! Flu shots can keep people healthy and out of the hospital. With so many misconceptions surrounding the flu shot, we need your help...