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Over-The-Counter (OTC) Allowance
https://www.caresource.com/benefits-services/pharmacy/otc/...Learn more at www.HealthyBenefitsPlus.com/CareSource. This is where you can check your balance, shop, find a store, get support and more! You can also get over-the-counter items through the Medicaid covered...
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Vendor Compliance FAQ
https://www.caresource.com/about-us/legal/corporate-compliance/vendor-compliance/frequently-asked-questions/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...
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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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Health Assessment & Screening
https://www.caresource.com/members/my-caresource-account/health-assessment-screening/...the HNS. To find the nearest kiosk location, visit https://my.pursuanthealth.com/locations. *You must complete the HNS within your first 90 days with CareSource to get the reward. If you complete the...
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How and When to File an Appeal
https://www.caresource.com/members/tools-resources/grievance-appeal/file-appeal/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...
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State Hearing and External Review
https://www.caresource.com/members/tools-resources/grievance-appeal/state-hearing-external-review/...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...
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Primary Care Provider Roles & Responsibility
https://www.caresource.com/providers/education/patient-care/pcp-roles-responsibilities/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....
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Fraud, Waste & Abuse
https://www.caresource.com/providers/education/fraud-waste-abuse/...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...
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Archived Reimbursement Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/reimbursement-policies/archived/...in a Hospital or 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...
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Healthy Indiana Plan (HIP) Benefits & Services
https://www.caresource.com/plans/medicaid/benefits-services/hip-benefits/...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...
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