Our Program Integrity Department handles cases of managed care fraud, waste or abuse. It can be done by providers, pharmacies, or members. Fraud means the purposeful misuse of or for...

...Department of Health Resources Please select your state resources below for specific COVID-19 vaccine guidance. Arkansas Department of Health Georgia Department of Public Health Indiana Department of Health Kentucky Public...

...of our health plan and the Ohio Department of Medicaid (ODM) as outlined in this manual. Providing 30 days of emergency coverage to any CareSource patient dismissed from the practice....

...with community stake holders to carry out this much needed work. Our Enterprise Life Services department is dedicated to serving marginalized communities and making a positive impact in the lives...

...free CME/CE credit! Resources CMS Webinars and Trainings US Department of Health and Human Resources (HHS) Think Cultural Health Our Commitment We are committed to improving our member’s health by...

...Abuse and Mental Health Services Administration (SAMHSA) – The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that...

...minimum of every three years and are considered to be recredentialed unless otherwise notified. Contracting and Recredentialing Process CareSource credentials providers using guidelines from the Ohio Department of Insurance (ODI)...

...Department of Community Health’s (DCH’s) central prior authorization portal for communicating prior authorization and precertification requests and their disposition. How do I request a retrospective review? Health partners have 180...

...The Ohio Department of Medicaid (ODM) has implemented the OMES to enhance the efficiency of the Next Generation MCOP. The full implementation of the OMES modules is underway, aimed at...

...phones. Include your emergency contact, the fire department, police department and local hospital. Make a kit with: food, water, extra cash, first aid items, a flashlight, a radio, a multi-purpose...