...Dental Claim Form Instructions Follow the instructions to fill out the American Dental Association’s (ADA) dental claim form. CareSource TMD Screening Examination Form Use this screening form to determine evidence...

...to request prior authorization to prescribe specialty pharmacy medications, as outlined in the CareSource member’s plan Preferred Drug List (PDL). Synagis Prior Authorization Request Form – Submit this form to...

CareSource PASSE™ strives to make it easy for you to work with us, whether online or over the phone. Key Contact Information Below is a list of the plan’s phone...

...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...

Make the Most of Your Plan Explore the pages on our website that will help you navigate and use your plan. Your Plan Documents Your Plan Documents Your plan documents...

...Dental Services Routine dental checkups and dental cleanings are covered under Hoosier Healthwise, HIP Plus, HIP State Plus, and HIP State Basic and HIP Maternity plans. You can find a...

Thank you for choosing us! We want you to be happy with your coverage. We offer a suite of online self-service tools, but you can always call Member Services with...

...point of contact Incentives and rewards for completing health and wellness activities Hearing Care Dental Care Vision Care Home and Community-Based Supports and Services (if eligible) Dental Good dental care...

...to your dentist are covered. Your dental benefits are provided by Liberty Dental®. Find dentists using Liberty Dental’s Provider Directory. You can also call Liberty Dental Member Services at 1-888-401-1128...

...no cost for members. The plan covers: Doctor visits Prescription medicine Mental health care Dental care Hospitalizations Surgeries Family planning Immunizations(shots) HHW Benefit Packages The State will let you know...