...Box 1940, Dayton, OH 45401-1940 You do not have to give us your name when you write or call. If you are not concerned about giving your name, you may...

...providers can expect the generic to produce the same effect and have the same safety profile as the brand name drug. If a brand name product is requested when a...

...also send an email* or fax us. Please give us as many facts as you can. Add names and phone numbers. If we do not get your name, we will...

...want to find a nearby in-network Pharmacy. Your member ID card shows your plan’s name. You will need your plan name to use the search tool. A screen like the...

...account by creating your username and password. For added security, set up the multifactor authentication. To connect your account, you will need your Provider Name, Tax ID, CareSource Provider ID...

...All internal appeal requests must have: The covered person’s name and ID number as shown on the ID card The provider’s name The date of the medical service The reason...

...information about becoming a participating provider, please submit the following information when completing the New Health Partner Contract Form. Your W-9 tax form Name Specialty CAQH ID number Tax ID...

...business hours, unless otherwise agreed upon. Staff members are identified by name, title and organization name when initiating or returning calls regarding UM issues. Staff members are available to accept...

...number will need to set up a new account using a unique email address as your username. To use single sign-on in the future, be sure to use the same...

...to 30 days to process. Authorized Representative Designation Form – Use this form to name someone who can speak on your behalf. Pre-Birth Selection Form – Use this form to...