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...

...Therapy, Occupational Therapy, and Speech-Language Pathology P Policy Development Process Program Integrity Provider Prepayment Review R Readmission Retrospective Authorization Review S Sentinel Events and Provider Preventable Conditions T Three-Day Window...

...Summary of Formulary/Prior Authorization Changes Effective January 1, 2026 12/01/2025 Summary of Formulary/Prior Authorization Changes Effective October 1, 2025 09/01/2025 Summary of Formulary/Prior Authorization Changes Effective July 1, 2025 06/01/2025...

...on when a prior authorization is required. You can also review our prior authorization list. Supplemental Benefits For 2026, CareSource Marketplace Plans feature the following supplemental benefits: TruHearing® provider network...

...planning or emergency services, out-of-network health care providers need prior authorization (also called pre-approval). Go to www.caresource.com/in/plans/medicaid/benefits-services/referrals-prior-authorization/ for more details on prior authorization. Office Visits / Hospital Type of Service...

...and preventive services do not need prior authorization. Many of these other services do require prior authorization. Call Member Services at 1-844-607-2829 (TTY: 711) to learn more. Dental Cleanings Yes...

...form to evaluate scaling and root planning. ODJFS Dental Services Prior Authorization Form Submit this form to the Ohio Department of Job and Family Services (ODJFS) to request prior authorization...

...Our ICD-10 resources include network notifications, frequently asked questions (FAQs), claim processing and preauthorization updates, as well as additional resources from the Centers for Medicare & Medicaid Services (CMS) and...

...Authorization Changes Effective October 1, 2025 09/01/2025 Summary of Formulary/Prior Authorization Changes Effective July 1, 2025 06/01/2025 Summary of Formulary/Prior Authorization Changes Effective April 1, 2025 03/01/2025 Summary of Formulary/Prior...

...A One Front Door approach has been established to simplify the submission of claims and prior authorizations. Submitting Claims and Authorizations Providers can submit claims and prior authorizations in two...