...– For certain drugs, we require you to first try another drug to treat your medical condition before we will cover the drug your physician initially prescribed. 2025 Step Therapy...

...Be treated with dignity and respect Receive Culturally and Linguistically Appropriate Services (CLAS) Have your personal and medical information kept private Participate in decisions about your health care, including the...

Utilization Management (UM) is when TrueCare™ reviews requests for certain health care services. The review can happen before, during, or after service. We will review the request for: Medical necessity...

Utilization Management (UM) is when TrueCare™ reviews requests for certain health care services. The review can happen before, during, or after service. We will review the request for: Medical necessity...

...day-to-day challenges. You may face challenges like your medical conditions or family history. The path to recovery starts here. You can also learn more about addiction services in your area...

...are paid for medically necessary services before, during and after an emergency or disaster. Giving guidance on HAPCareSource.com for members and providers before, during and after an emergency or disaster....

...to treat your medical condition before we will cover the drug your doctor initially prescribed. 2025 Step Therapy Criteria Last updated on 12/01/2025 2025 Part B (Medical Drug) Step Therapy...

...request a phone call. If our Care Management staff feels their services would be helpful to you or your family. Our staff is trained to help you with medical problems...

...claim. At a minimum, the dispute submission must include: Claim payment disputes must be submitted in writing. If your denial involves a denied authorization request involving a medical necessity review...

...your medical care. Learn more in Chapter 9 of your Evidence of Coverage. How to File a Grievance Phone: Call Member Services. Mail: Send your grievance to CareSource Dual Advantage...