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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...

...Department Electrocardiogram (EKG_ECG) Experimental and Investigational Item or Service F Fraud, Waste and Abuse Recovery Process I Itemized Billing M Medical Necessity Determinations Medical Record Documentation Standards for Practitioners Molecular...

...Quality Department reviews these measures: Healthcare Effectiveness Data and Information Set (HEDIS) to measure performance on dimensions of care and service Health Outcomes Survey (HOS) to assess patient reported outcomes...

...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...

...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...

...Services department will answer your calls from 8 a.m. to 6 p.m., Monday through Friday. To find the direct phone numbers for your needs, please visit the Contact Us pages...