Definitions CareSource provides several opportunities for you to request review of dispute or authorization denials. Actions available after a denial include: Claim Appeals A claim appeal is a written request...

...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,...

Before providing care or prescribing medicine for your patients, please review the CareSource® MyCare Ohio (HMO D-SNP) Medicare Part D formulary and Medicaid List of Covered Drugs. Formulary Use the...

...Call at least two business days before you need a ride. Resources: Resources Link FSSA Benefits Portal FSSABenefits.IN.gov Video: Creating an FSSA Portal Account https://www.in.gov/medicaid/members/files/Benefits-Portal-Flyer.pdf https://www.in.gov/medicaid/members/files/Benefits-Portal-Flyer_SPA.pdf https://www.in.gov/medicaid/members/files/Benefits-Portal-Flyer_BUR.pdf Video: FSSA Benefits...

...Ohio Administrative Code – Chapter 5160-26 – View managed care plan requirements from the Ohio Administrative Code. Ohio Revised Code – Chapter 5167 – View Medicaid managed care requirements from...

Dave Thomas is the president of CareSource’s Ohio market and brings more than 35 years of experience driving strategic growth and market expansion across the government programs sector. Before joining...

...Medicare and Medicaid Services (CMS) Latest ICD-10 News Centers for Medicare and Medicaid Services (CMS) Ohio Department of Medicaid Additional Resources Workgroup for Electronic Data Interchange (WEDI) American Academy of...

CareSource PASSE™ follows Arkansas Medicaid’s evidence-based Prescription Drug Program, Preferred Drug List (PDL) and Prior Authorization Criteria. Search Tips: To access the downloadable Preferred Drug List and Prior Authorization Criteria...

...The Ohio Department of Medicaid (ODM) has implemented the OMES to enhance the efficiency of the Next Generation MCOP. The full implementation of the OMES modules is underway, aimed at...

...CareSource® MyCare Ohio (Medicare-Medicaid Plan). You will find key information that will make it easier to do business with us and assist you in serving our members. MyCare Ohio Resources...