...Medicaid’s covered OTC list. Additional information on pharmacy claim submission and prior authorization is available on the Pharmacy page. Drug Formulary Changes Each quarter, there may be changes to the...

...RadMD’s website. Pharmacy Prior Authorization Some drugs may require prior authorization before they will be covered. Please refer to the Pharmacy page to review these requirements. For drugs processed through...

...billed on a HCFA 1500 form and on a claim that does not contain other service codes outside of these four codes. Billing these codes does not guarantee payment. Providers...

...Prior Authorization Form Submit this form to request prior authorization to prescribe Hyaluronic Acid Injections covered and reimbursable by CareSource. Ohio Department of Medicaid (ODM) Pharmacy Prior Authorization Forms Visit...

...12 Exemptions When the above codes are billed in the below scenarios, the claims are not subject to EVV validation: Telehealth: Home Health and Private Duty Nursing services provided through...

...fraud, waste and abuse. If you have any questions about these examples or Fraud, Waste and Abuse in general, please send an email to: Fraud@CareSource.com. Provider: Billing for non-covered, medically...

...list of valid service codes. You will use this paper claim process until you can log in to the provider portal and access your service plan. To ensure that we...

...more. View Forms Provider Administered Drugs Look up coverage of medications covered under the medical benefit on the Procedure Lookup tool and review policies on the Pharmacy Policies page Provider...

Please select your state. CareSource plans provide comprehensive, quality coverage that you can afford, understand and use. We offer individual and family plans with adult vision and fitness coverage. Benefits...