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Medical Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/medical-policies/These medical policies apply to the CareSource plan. Medical policies offer guidance on determination of medical necessity and appropriateness of care for approved benefits. Benefit determinations and coverage decisions are...
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Become a Participating Provider
https://www.caresource.com/providers/education/become-caresource-provider/Florida TRICARE Florida TRICARE Learn More Georgia TRICARE Georgia TRICARE Learn More Michigan Michigan Learn More Mississippi Mississippi Learn More North Carolina North Carolina Learn More Nevada Nevada Learn More...
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Benefits and Services
https://www.caresource.com/plans/marketplace/benefits-services/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...
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Grievance and Appeal
https://www.caresource.com/members/tools-resources/grievance-appeal/...A decision we make about the payment for a Part D drug or an exception to our formulary. Organization Determination – A decision we make about covering a medical service...
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Pregnancy & Family Planning
https://www.caresource.com/members/education/pregnancy/...alcohol or use illegal drugs While You Are Pregnant You can find a network provider at findadoctor.CareSource.com. Seeing your provider on a routine basis while you are pregnant can spot...
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Health Care Terms
https://www.caresource.com/members/education/health-care-terms/...and make a healthy home. Medication Assisted Treatment (MAT) MAT helps ease cravings for drugs or alcohol and has two parts. One part is prescription medicine. It is used in...
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Caregiver Resources
https://www.caresource.com/members/tools-resources/caregiver-resources/...Find network providers or drug coverage information for your loved one. These resources will help you work with us to make sure your loved one gets the best care possible....
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Quality Improvement
https://www.caresource.com/providers/education/quality-improvement/Our Quality Improvement (QI) Program is designed to ensure the organization delivers on all aspects of care delivery for beneficiaries based on their unique needs. We monitor, analyze and identify...
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Reimbursement Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/reimbursement-policies/...D E F G H I J K L M N O P Q R S T U V W X Y Z # 340B Drug Pricing A Applied Behavior...
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Quality Improvement
https://www.caresource.com/members/tools-resources/quality-improvement/...to talk about changing the drugs if they make you sick or cause an allergic reaction. Don’t stop taking your medication until you talk to your doctor. Questions? Call Member...
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