...on Fingertip Formulary, a medical application you can download to your mobile device. CareSource uses a Preferred Drug List (PDL), or formulary, that is updated quarterly. You can view an...

...Providers may not charge members for services which CareSource PASSE™ denied based on lack of medical necessity or lack of compliance to contractual terms. Providers may not bill members for...

...up to date with vaccinations is important. Varies by vaccine. Discuss with your PCP. Diabetes Self-Management Education* Get a referral from your PCP to join a diabetes education program. These...

...for check-ups and screenings. Expanded Drug Formulary: Easier access to the drugs that you need to treat your heart condition. Medication Management: Support from pharmacists to manage heart and other...

...benefits too! OTHER PLAN HIGHLIGHTS INCLUDE: A strong network of providers: including networks for diabetes targeted health systems and other provider specialties for complex symptom management. Specialist visits do not...

...dental exams once a year. Medically Necessary Follow-Up Care EPSDT also covers medically necessary care for issues found by an exam. This could include, but is not limited to, services...

...Faster feedback on claim status Minimal staff training or cost Three types of claims may be submitted: Professional medical office claims Institutional claims Instructions for Network Providers: Submitting Claims to...

...services Audit services Fraud and abuse detection programs Business planning, management and general administration Case and Utilization Management Humana – CareSource may use your medical information to approve services or...

...Medicine and affiliated with White River Medical Center, Ozark Health Medical Center, Stone County Medical Center and Unity. Dr Zini served on the Board of AFMC for 10 years and...

CareSource will pay for your prescription drugs and some prescription medical supplies at the pharmacy. Some examples are diabetic supplies, inhaler spacers, peak flow meters, syringes, needles, alcohol wipes and...