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...

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...

...envelope. Go to a Pursuant Health kiosk. Kiosks are located in Indiana Walmart® pharmacies. Watch your mail for instructions on how to complete the HNS. To find the nearest kiosk...

To learn more about appeals and how to file an appeal for your plan, choose your plan from the drop down list above, then click GO. An appeal is how...

...120 days of getting CareSource’s finding. Reviews are done within 90 days for standard reviews or within 72 hours for expedited (fast) reviews. This will be final and CareSource will...

All CareSource members choose or are assigned to a primary care provider (PCP) when they enroll in the plan. They can change to another network PCP as often as needed....

...Pharmacy Fraud, Waste & Abuse Examples of pharmacy fraud, waste and abuse: Prescription drugs not dispensed as written Submitting claims for a more expensive brand name drug when a less...

...Ambulatory Surgery Center Dental Services Rendered in a Hospital or Ambulatory Surgery Center Drug Testing Drug Testing Drug Testing Drug Testing Drug Testing Dry Eye Syndrome Testing Durable Medical Equipment...

...Medicine HIP Plus HIP Basic Copays may apply HIP Maternity HIP State Plus HIP State Basic Copays may apply Prior Authorization Needed? Preferred Drug List (PDL) Drugs Yes Yes Yes...

...evaluations of over 60 standards and selected HEDIS® measures. A team of physicians and health plan experts conduct accreditation surveys. A national oversight committee of physicians analyzes the team’s findings...