...This includes providers that perform in-office surgeries. These services should be available at no cost to the member. Submit the Interpreter Service Request Form (coming soon) to request interpretation services...

...use, and can help stop drug misuse. Please fill out this form to get your DisposeRx packet. Drug Take Back Day The U.S. Drug Enforcement Administration (DEA) sponsors the National...

...West Virginia Health Coverage Programs and CareSource require that you submit your National Provider Identifier (NPI) number to CareSource along withthe completed West Virginia uniform credentialing and recredentialing form.Also complete...

...Interest FormCareSource JobConnect Interest FormCareSource JobConnect Interest Form CareSource JobConnect™ was developed with one goal in mind – to support members who would like help reaching their education and/or employment...

...Urine Drug Screening Prior Authorization Form – Submit this form when requesting prior authorization for urine drug screenings Submit the SUD 1115 Waiver Universal PA Form to request prior authorization...

The links below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here. Latest Updates Date Status COVID-19: 2022 Vaccination Program Update 01/10/2022...

...o se nos exige que compartamos su información de otras formas. Dichas formas a menudo son para ayudar al bien público, como la salud pública o una investigación. Debemos cumplir...

...food Let’s Get Started To connect with CareSource Life Services®, call 1-844-543-73781-844-607-28281-844-607-2832 or email LifeServices@CareSource.comLifeServicesGeorgia@CareSource.comLifeServicesIndiana@CareSource.com. To learn more, please fill out our online formonline formonline form. This is all provided...

...TrueCare™ on behalf of a member, you will need written consent. Member Consent/HIPAA Authorization Form: This form will give us permission to speak with a caregiver about a member’s medical,...

...differ from state to state. To make sure your wishes are heard, you should use a form that you know is legal in the state where you live. Below is...