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End or Change Membership
https://www.caresource.com/members/tools-resources/grievance-appeal/change-plans/...of eligibility Existing members – 12 months from the last redetermination date Have the Social Security number and/or DOB handy for the Head of Household Medicaid Member. Other DFCS info...
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Quality Improvement
https://www.caresource.com/providers/education/quality-improvement/...areas, including Utilization Management, Care Management and Pharmacy services Medical, Behavioral Health and Intellectual Developmental Disabilities services Member and Provider satisfaction Quality of care and member safety Service delivery in...
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Check Eligibility
https://www.caresource.com/providers/provider-portal/check-eligibility/...the member ID card is available in the Member ID Card Flier. Member Consent When you check eligibility on the Provider Portal, you can also determine if a member has...
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Primary Care Provider Roles & Responsibility
https://www.caresource.com/providers/education/patient-care/pcp-roles-responsibilities/...member use. All CareSource® members choose or are assigned a primary care provider (PCP) upon enrollment in the plan. PCPs should help facilitate a medical home for members. This means...
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Provider Disputes or Appeals
https://www.caresource.com/providers/provider-portal/appeals/...CareSource determines, or the provider indicates in making the request on the member’s behalf or supporting the member’s request, that the standard resolution time frame could seriously jeopardize the member’s...
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Pharmacy
https://www.caresource.com/providers/education/patient-care/pharmacy/...accepted if the member is suffering from a serious condition that requires urgent treatment. Members may also submit a formulary exception via phone, fax or an online form – Member...
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Member Overview
https://www.caresource.com/members/...Coordination Behavioral Health My CareSource My CareSource Quickly view your member information, ask for a new member ID card and more. Most Popular About My CareSource Get a New ID...
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Member Rights & Responsibilities
https://www.caresource.com/plans/marketplace/plan-documents/rights-responsibilities/...health services in the receipt of health services. Consult our website or newsletters annually for any updates to member rights and responsibilities. Your Membership Rights As a member of HAP...
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Quick Start Steps for New Members
https://www.caresource.com/members/tools-resources/quick-start-guide/quick-start-steps/...online account. You will need your member ID number from your ID card or new member kit welcome letter. You’ll also need to enter a secure password. You can use...
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CareSource JobConnect for Members
https://www.caresource.com/members/tools-resources/life-services/members/...the CareSource JobConnect Program? CareSource JobConnect serves members that are: CareSource members or parents/legal guardians of a minor child who is a CareSource member Over the age of 16 Over...
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