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False Claims Act
https://www.caresource.com/providers/education/fraud-waste-abuse/false-claims-act/...should also report this to the Program Integrity department. TRICARE Prime® Demo by CareSource Military & Veterans™ is required to comply with certain provisions of the Deficit Reduction Act. One...
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Benefits & Services
https://www.caresource.com/plans/tricare-prime-demo/benefits-services/TRICARE Prime® Demo by CareSource Military & Veterans™ is more than just quality health insurance. We care about YOU. Our benefits and services go beyond basic care. You get: Preventive...
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Claim Rejection Notifications
https://www.caresource.com/providers/provider-portal/claims/claim-rejection-notifications/...Rendering provider. It is a Kentucky state requirement that all claims must have valid NPI & Taxonomy codes for both the Billing and Rendering provider that are found in the...
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Eligibility and Enrollment
https://www.caresource.com/plans/tricare-prime-demo/eligibility-and-enrollment/...& VeteransTM: Active-duty family members Family members of Guard/Reserve sponsors who are activated Retirees, retiree family members, survivors who aren’t eligible for Medicare Beneficiaries enrolled in the Transitional Compensation Program...
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Mental Health
https://www.caresource.com/providers/education/patient-care/mental-health/At TRICARE Prime® Demo by CareSource Military & Veterans™, we streamline our business practices to limit the administrative burden on you and our beneficiaries. Our goal is to make it...
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Reimbursement Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/reimbursement-policies/These reimbursement policies apply to the TRICARE Prime® Demo by CareSource Military & Veterans™ plan. Reimbursement policies are designed to assist you when submitting claims to us. They are routinely...
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Pharmacy Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/pharmacy-policies/These pharmacy policies apply to the TRICARE Prime® Demo by CareSource Military & Veterans™ plan. These pharmacy policies apply to our Georgia Medicaid plan(s). Pharmacy policies offer guidance on determination...
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Behavioral Health
https://www.caresource.com/providers/education/patient-care/behavioral-health/...& Well-Being BH Screener CAGE-AID (coming soon) BH Screener PHQ-9 (coming soon) Care and Disease Management Forms Opioid Tool Kit Pregnancy Provider Portal Suicide Prevention Tool Kit Transportation & Interpreter...
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Administrative Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/administrative-policies/...necessity, investigational and experimental services. These administrative policies apply to the TRICARE Prime® Demo by CareSource Military & Veterans™ plan. Administrative policies offer guidance on determination of medical necessity, investigation...
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Fraud, Waste & Abuse
https://www.caresource.com/members/tools-resources/fraud-waste-abuse/...when they are not needed. Abuse is action that causes unneeded costs to CareSource Military & Veterans (CSMV). Please report it in one of these ways: Call 1-844-415-1272 (TTY: 711)....
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