A grievance is a formal complaint about us, our providers or the care you get. You or an authorized representative may file a grievance at any time. Call Member Services...

...care. Review and approval of the guidelines are completed by Michigan Quality Improvement Consortium (MQIC), managed by the Michigan Association of Health Plans. The approved guidelines are then presented to...

...Next Generation Managed Care: Prior Authorization and Claims Quick Reference Guide ODM Telehealth Billing Provider Reference Guide Opioid Tool Kit Provider Attestation FAQs Provider Immunization Guide Provider Portal: Assessments and...

...President, Ohio Market. Steve has held multiple executive roles in the managed care industry. Before joining CareSource, his career history included record accomplishments at ChoiceCare/Humana where among other positions he...

...since 2012, where he first served as director of network development for the Indiana Market. During his tenure, he expertly managed provider relationships and led the contracting process for new...

...1-833-711-0773 (TTY: 711) Ohio Resilience through Integrated Systems and Excellence (OhioRISE) is a specialized Medicaid managed care program that focuses on children and youth who have complex behavioral health and...

...of Medicaid managed health plan experience and the local expertise of one of Michigan’s most trusted names in health insurance, we have the opportunity to be a powerful combination of...

...markets and products. Fred Schulz Chief Operating Officer Fred A. Schulz is the Chief Operating Officer (COO) at CareSource, a nationally recognized nonprofit managed care organization. Fred has a strong...

The policies below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here. # A B C D E F G H I...

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...