...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...

The frequently asked questions below are intended to help First Tier, Downstream and Related Entities (FDR) understand and manage their compliance efforts. Please click on the expandable menus below to...

...Documentation Standards C Claims Editing and Review Continuity of Care Court Mandated Health Services COVID-19 Vaccination E Emergency Department Electrocardiogram (EKG_ECG) Experimental and Investigational Item or Service F Fraud, Waste...

...focused on advancing aging and health initiatives and served as a managed care analyst at the U.S. Department of Health and Human Services under two administrations. Susan leads a multidisciplinary...

...looked at, and reported to evaluate the care you receive. Our Quality Department reviews these measures: Healthcare Effectiveness Data and Information Set (HEDIS) to measure performance on dimensions of care...

...Directives (a written record of your wishes for medical care). To be free to carry out your rights and know that CareSource, our providers, or the Georgia Department of Community...

...within 90 days of becoming a member. If you would like more information about the program, please contact our Member Services department at the number below. We can help you...

...get, based on established criteria or guidelines. We review to make sure it is the best care for your needs. The UM department performs activities such as: prior authorization (PA),...

At CareSource PASSE we know that good health means more than just taking care of physical needs. It means addressing the health of mind, body and spirit. Suicide and Crisis...

...find a copy of the PDL on the Ohio Department of Medicaid website or on the Gainwell pharmacy website. Please call Gainwell Member Services at 1-833-491-0344 (TTY: 1-833-655-2437) if you...