...(Periodontics)* Root Canals Routine Tooth Extractions Surgical Extractions* & Other Oral Surgery * Approval or prior authorization required. We cover routine eye exams and eyewear. If you are under the...

Provider Attestation Form – Submit this form to attest to practice competency prior to working with CareSource. CCVS Provider Authorization and Release Form – Submit this form to authorize release...

...more. Call Member Services to ask about our list of covered medications and those that need prior authorization. Medication Therapy Management, or MTM, is a service we offer at no...

...1, 2019 03/01/2019 Member Web Summary of Formulary Changes Effective January 1, 2019 12/01/2018 Notification Date Posted Summary of Formulary/Prior Authorization Changes Effective April 1, 2026 03/01/2026 Summary of Formulary...

...increases access to necessary medications such as MAVYRET for Medicaid beneficiaries by removing the prior authorization requirements and dispensing the medication in an eight-week supply (or a 12-week supply, when...

...requests, please send a letter of representation and compliant HIPAA authorization to: CareSource Attn: Office of General Counsel 230 N. Main St Dayton, OH 45402 P: 937.531.2424 F: 937.487.1921 legalsubrogation@caresource.com...

...make sure that we have access to your provider application before you submit your CAQH number as referenced above: Log on to CAQH using your account information. Select the Authorization...

...verify procedures and payment mechanisms are compliant. Our proactive monitoring includes prepay review edits, prior authorization monitoring, analytic performance dashboard monitoring, and verification of services. Our reactive monitoring includes data...

...a exam. Make sure to ask for a Healthchek exam when you call. Some of the tests and treatment services may need prior authorization. Mothers should have prenatal exams and...

...HITECH violations are: Disclosing member PHI to an unauthorized third party Using member PHI for an unauthorized purpose Accessing member PHI without proper authorization Failing to maintain the Security of...