Before providing care or prescribing medicine for your patients, please review the CareSource® MyCare Ohio (HMO D-SNP) Medicare Part D formulary and Medicaid List of Covered Drugs. Formulary Use the...

...submit an expedited appeal. Documentation for Good Cause for late filing of an appeal will be reviewed. An AOR form or equivalent is required for expedited preservice appeals if submitted...

...do not apply to you. You are responsible for the costs of all health care services you received when the policy is not effectuated. Prescription Drug Formulary Your plan uses...

...Toolkit Coronavirus (COVID-19) Partner Toolkit Centers for Medicaid and Medicare Services (CMS) Go To Toolkit Vaccine Toolkit Vaccine Toolkit Centers for Disease Control and Prevention (CDC) View Vaccine Toolkit For...

...be sure to attach your W-9 form when you submit this online form. Overpayment Recovery Form (Coming Soon) Submit this form to offset overpaid claims against a future payment. Payment...

...enrolled in Medicaid and PeachCare for Kids® and women enrolled in Planning for Healthy Babies® (P4HB®). You can choose CareSource if you are eligible for Georgia Families® and P4HB® benefits...

...least one that addresses children and adolescents Be based on perinatal care, care for children up to 24 months of age, care for children 2-19 years of age, care for...

...for medical necessity. The retrospective review request must include a copy of the other carrier’s EOP. All requests for services will be reviewed for timeliness and medical necessity. Health partners...

...The following is a list of available Prior Authorizations Forms: ABA Prior Authorization Form CES Waiver Prior Authorization Form Community Based/Behavioral Health Outpatient Prior Authorization Form EIDT/ADDT and ST/PT/OT Prior...

...Department of Medicaid (ODM) for submitting provider applications, credentialing request and provider demographic updates. The PNM module is the single point for providers to complete provider enrollment, centralized credentialing, and...