...Change Form. Once complete, email the form to providernetwork@hap.org with the subject line: Provider Change Form. In the body of the email, be sure to include: Type 1 NPI Type...

...Determination Online: Complete the Coverage Determination Request Form online. Call: Member Services Fax or Mail: Download the Coverage Determination Request Form and fax or mail it to us. Fax: 1-877-251-5896...

...money or property; Is authorized to make or deliver a document certifying receipt of property used, or to be used, by the government and, intending to defraud the government, makes...

...supplies and enteral formula face masks, hand sanitizer and patient gowns Your doctor can help you get the equipment if you need it. Important phone numbers In case of an...

...to 937-531-2398. If you have chosen an authorized representative, remember to fill out the Appointment of Representative Form. We will give you an answer to your appeal in writing within...

...regarding CareSource’s member rights and responsibility policy How can I get information sent to me in paper form? You can request information be sent to you in paper form. This...

...Fraud) Written Report: Use the Fraud, Waste and Abuse Reporting Form on www.caresource.com or write a letter and send to: CareSource Attn: Special Investigations Unit P.O. Box 1940 Dayton, OH...

...books, bingo or poker, or any other form of solicitation. Release: You acknowledge and agree that you are solely responsible for your User Content and any related content uploads, posts,...

...the right to: File a complaint (also called a grievance) File an appeal Ask for an external review Authorized Representative In order for CareSource to talk to your authorized representative,...

...social security number). If you wish to communicate such information please use one of our secure websites, web forms, or phone numbers/mailing addresses provided. If you choose not to provide...