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Quality Improvement Program
https://www.caresource.com/members/tools-resources/quality-improvement/qip/...Medicare and Medicaid Services (CMS) Meeting the requirements of the CareSource Indiana contract with the Office of Medicaid Policy and Planning Establishing safe clinical practices throughout the network of providers...
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Reimbursement Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/reimbursement-policies/...determined based upon a review of the actual services provided to a beneficiary and will be determined when the claim is received for processing. Providers and their office staff are...
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Diabetes
https://www.caresource.com/plans/marketplace/diabetes/...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...
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Claim Rejection Notifications
https://www.caresource.com/providers/provider-portal/claims/claim-rejection-notifications/...at 1-800-488-0134 or visit https://www.caresource.com/providers/ for instructions. Error Number: 132 Error Description: Missing/Invalid Medicaid ID for Atypical Provider How to Fix: Ensure correct Medicaid ID is provided. Error Number: 187...
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Medical Benefits
https://www.caresource.com/plans/dsnp/benefits-services/medical-benefits/...by selecting Dual Special Needs from the list. Network Exceptions It is important to know which providers are part of our network because, with limited exceptions, while you are a...
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Next Generation Managed Care
https://www.caresource.com/providers/tools-resources/next-generation-managed-care/...System (OMES) Provider Network Management (PNM) module, which will reduce administrative burden on providers. Also, the Single Pharmacy Benefit Manager (SPBM) will begin providing pharmacy services across all managed care...
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Care During A Disaster
https://www.caresource.com/members/education/disaster-readiness/...this means: Covering services without any limits or need of a prior authorization. This includes services done by out-of-network providers. Using a special claims payment process to make sure providers...
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Model of Care Training
https://www.caresource.com/providers/education/patient-care/model-of-care-training/...Needs Plans (D-SNPs) to provide initial and annual Model of Care (MOC) training to all network providers contracted to see dual-eligible members and all out-of-network providers seen by dual-eligible members...
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Update Practice Information
https://www.caresource.com/providers/provider-portal/update-practice-information/...New Health Partner Contract Form. Ohio Medicaid and CareSource MyCare Ohio providers should utilize the Provider Network Management (PNM) module from the Ohio Department of Medicaid for submitting provider applications,...
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Telehealth
https://www.caresource.com/members/tools-resources/where-to-get-care/telehealth/Telehealth uses your phone, computer, or tablet to speak to a provider. It removes the stress of needing transportation to and from the provider’s office. You can talk to a...
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