...know. Get Started Reporting Fraud, Waste & Abuse Reporting Fraud, Waste & Abuse Report a provider, pharmacy or member you feel is committing fraud, waste, or abuse. Get Started Quality...

...and population health principles To provide exposure to the various types of jobs for pharmacists in managed care To demonstrate how managed care organizations use data to scan for fraud,...

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...

...health insurance. Give information that CareSource and your health care providers need, to the extent possible, to give care. Tell us of suspected fraud as described in the Fraud, Waste...

...Investigational Item or Service Experimental or Investigational Item or Service Experimental, Investigational and Other Non-Covered Services F Fraud, Waste and Abuse Recovery Process I Intellectual or Developmental Disabilities (IDD) Documentation...

...act that constitutes fraud under applicable federal or state law. FWA is short for fraud, waste, and abuse Health Information Technology for Economic and Clinical Health (HITECH) Act is law...

...demographic and practice information is up to date for directory and member use Reporting suspected fraud and/or abuse Providing “live voice” coverage after normal business hours which may include an...

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cdmvheart Care Coordination What is a care coordinator? A care coordinator will connect you and your family with community support. They coordinate the services you are already getting and any...

CareSource is Health Care with HeartⓇ. We know understanding health care can be confusing. We strive to make it easy for doctors, members and the community to work with us,...