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Medical Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/medical-policies/...These medical polices apply to our Kentucky Marketplace plans. These medical polices apply to our West Virginia Marketplace plans. These medical policies apply to CareSource® Dual Advantage™ (HMO SNP) plans....
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Accreditations
https://www.caresource.com/about-us/accreditations/NCQA HEALTH PLAN ACCREDITED Georgia Marketplace Georgia Medicaid Indiana Marketplace Indiana Medicaid Michigan Medicaid Michigan Medicare Nevada Marketplace Nevada Medicaid Ohio Marketplace Ohio Medicaid West Virginia Marketplace Wisconsin Marketplace NCQA...
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Navigator / Assister Training
https://www.caresource.com/producers/navigator-assister-training/...Georgia Marketplace Navigator Presentation 2026 Indiana Marketplace Navigator Presentation 2026 Nevada Marketplace Navigator Presentation 2026 Ohio Marketplace Navigator Presentation 2026 West Virginia Marketplace Navigator Presentation 2026 Wisconsin Marketplace Navigator Presentation...
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Updates & Announcements
https://www.caresource.com/providers/tools-resources/updates-announcements/...Change 05/22/2026 Announcing Non-Renewal of Health Insurance Marketplace and Off-Exchange Plans 05/20/2026 May 2026 Policy Updates 05/01/2026 Remittance Advice Service Date Correction – Revision 04/23/2026 Remittance Advice Service Date Correction...
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Plans
https://www.caresource.com/plans/...Demo Indiana Indiana Healthy Indiana (HIP) Hoosier Healthwise (HHW) Marketplace Kentucky Kentucky MARKETPLACE Michigan Michigan Medicaid MI Coordinated Health Marketplace Nevada Nevada Medicaid Marketplace North Carolina North Carolina MARKETPLACE Ohio...
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Prior Authorization
https://www.caresource.com/providers/provider-portal/prior-authorization/CareSource® evaluates prior authorization requests based on medical necessity, medical appropriateness, and benefit limits. Services That Require Prior Authorization Please refer to the Procedure Code Lookup Tool to check whether...
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Get Credentialed
https://www.caresource.com/providers/education/become-caresource-provider/get-credentialed/...areCareSource Dual Advantage™ (HMO SNP) isCareSource MyCare ohio isCareSource isCareSource Marketplace Indiana isCareSource Marketplace KentuckyCareSource Marketplace West Virginia is listed as an authorized health plan. If not, check the Authorized...
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Provider Disputes or Appeals
https://www.caresource.com/providers/provider-portal/appeals/Definitions CareSource provides several opportunities for you to request review of dispute or authorization denials. Actions available after a denial include: Claim Appeals A claim appeal is a written request...
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Benefits and Services
https://www.caresource.com/plans/marketplace/benefits-services/...Update For 2025, CareSource Marketplace Plans feature the following benefits: TruHearing® provider network for hearing services is included with all plans. EyeMed® provider network for vision services on all plans...
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Training & Events
https://www.caresource.com/providers/education/training-events/Earn rewards for keeping your patients healthy! Flu shots can keep people healthy and out of the hospital. With so many misconceptions surrounding the flu shot, we need your help...
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