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Health Care Terms
https://www.caresource.com/plans/dsnp/benefits-services/behavioral-health/health-care-terms/...or whole day. Outpatient Services A service that can be done without an overnight stay in the hospital. Partial Hospitalization Program (PHP) Services PHP is an outpatient therapy program that...
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State Hearing and External Review
https://www.caresource.com/members/tools-resources/grievance-appeal/state-hearing-external-review/...who will go to the hearing include you and others acting for you with your written consent. There will also be CareSource agents and a fair Administrative Law Judge. In...
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Claim Rejection Notifications
https://www.caresource.com/providers/provider-portal/claims/claim-rejection-notifications/...Description: Claim is rejected because either Provider NPI is inactive due to CAF or indictment. How to Fix: Providers who are not actively enrolled with ODM due to termination for...
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Rights & Responsibilities
https://www.caresource.com/plans/medicaid/plan-documents/rights-responsibilities/...be given information about your health. This information may also be available to someone who you have legally authorized to get information on your health. This person could be reached...
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Pharmacy
https://www.caresource.com/plans/medicaid/benefits-services/pharmacy/CareSource will pay for your prescription drugs and some prescription medical supplies at the pharmacy. Some examples are diabetic supplies, inhaler spacers, peak flow meters, syringes, needles, alcohol wipes and...
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Lock-In Program
https://www.caresource.com/plans/medicaid/benefits-services/pharmacy/lock-in-program/Coordinated Services Program (CSP) CSP is a health and safety program that protects members whose use of services exceeds medical necessity. Use of controlled substances is monitored, and members are...
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Medical Benefits
https://www.caresource.com/benefits-services__trashed/medical/CareSource has a network of doctors, hospitals and other providers. If you use providers who are not in our network, the plan may not pay for these services unless you...
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Waiver Services
https://www.caresource.com/plans/mycare/benefits-services/waiver-services/...aide services Home delivered meals Chore services Home modification With waiver services, you will have a Care Manager who approves services based on your needs using a Service Plan. It...
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Eating Healthy
https://www.caresource.com/members/education/eating-healthy/...to you. Call 1-800-755-GROW (4769) or visit signupwic.com. WIC helps pay for groceries for you and your family. You can get: Dairy like milk, yogurt, and cheese; Whole grains like...
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Patient Care
https://www.caresource.com/providers/education/patient-care/At TRICARE Prime® Demo by CareSource Military & Veterans™, everything we do is centered on improving the lives of our beneficiaries– your patients. Our Patient Care webpages provide information and...
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