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Prior Authorization
https://www.caresource.com/providers/provider-portal/prior-authorization/...Non-Participating Providers Prior authorization must be obtained before sending patients to nonparticipating providers, with the following exceptions. Emergency Services All in-patient services require prior authorization. Please call 1-833-230-2101 to obtain...
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Utilization Management
https://www.caresource.com/providers/education/patient-care/utilization-management/...detailed information. Transition of Care CareSource will coordinate continuity of care for members who have existing care treatment plans that include scheduled services with non-participating health partners or who transition...
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Provider Manual
https://www.caresource.com/providers/tools-resources/provider-manual/...Services at 1-855-202-1058. Transition of Care CareSource will coordinate continuity of care for members who have existing care treatment plans that include scheduled services with non-participating health partners or who...
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Claims
https://www.caresource.com/providers/provider-portal/claims/...Sheet Submit this cover sheet and itemized statement for high dollar claims. Non-Participating Provider Profile Form (Coming Soon) Non-participating providers may submit claims to CareSource using this form. CareSource is...
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Archived Reimbursement Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/reimbursement-policies/archived/The policies below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here. # A B C D E F G H I...
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Quality Improvement
https://www.caresource.com/providers/education/quality-improvement/Our Quality Improvement (QI) Program is designed to ensure the organization delivers on all aspects of care delivery for beneficiaries based on their unique needs. We monitor, analyze and identify...
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