...or our providers, you or your authorized representative can let us know. In order for CareSource to talk to your authorized representative, you and your authorized representative must complete the...

...make reasonable efforts to provide the member with prompt oral notification of the delay and applicable grievance rights. CareSource will notify the member and their authorized representative in writing of...

...ending. You can appeal if you disagree. You must ask for one within 60 days from the date listed on the letter. You or an authorized representative can file. Call...

...were held. We will notify network providers that you are no longer in the grace period. We recommend that you contact your Pharmacy to have your Prescription Drug claims reprocessed....

...Representative Form English | Spanish An appointed representative is a relative, friend, advocate, doctor or other person authorized to act on your behalf in filing a grievance, coverage determination or...

...health plan reporting, annual Healthcare Effectiveness Data and Information Set (HEDIS®). In addition, Marketplace members complete the annual Quality Health Plan (QHP) Enrollee Survey to capture member perspectives on health...

...involve benefits or denial of benefits. The Grievance Process You or your authorized representative may file a grievance verbally or in writing. You or your authorized representative can file a...

...Authorization Statistics Please access the Pharmacy Prior Authorization Transparency Act Report to view the latest statistics. Please access the Utilization Management Prior Authorization Transparency Act Report to view the latest...

...department. Information may be reported anonymously. In addition, federal and state law and CareSource PASSE policy prohibits any retaliation or retribution against persons who report suspected violations of these laws...

...Committee (part of the Department of Community Health (DCH).) The request can be made by you, a parent/guardian, or other representative. A representative is a person you allow to make...