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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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Medicaid
https://www.caresource.com/plans/medicaid/...assigned to a health plan other than CareSource, you can switch within 90 days by calling the Ohio Medicaid Consumer Hotline at 1-800-324-8680. Ohio Medicaid’s managed care plans Ohio Medicaid’s...
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Next Generation Managed Care
https://www.caresource.com/providers/tools-resources/next-generation-managed-care/...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...
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Pharmacy Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/pharmacy-policies/...medications are managed under the Medical Benefit at CareSource. For medications payable through Gainwell Technologies, the Single Pharmacy Benefit Manager, please visit https://spbm.medicaid.ohio.gov/ or https://pharmacy.medicaid.ohio.gov/unified-pdl. # A B C D...
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Pharmacy Residency Program
https://www.caresource.com/providers/education/patient-care/pharmacy/pharmacy-community-programs/pharmacy-residency-program/...to be treated with compassion, dignity, and respect. It has become our heartbeat. Health care reform has been a catalyst for unprecedented CareSource growth. The company, headquartered in Dayton, Ohio,...
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Behavioral Health Carve-In
https://www.caresource.com/providers/education/patient-care/behavioral-health-carve-in/...Authorization process can be found on the CareSource Prior Authorization page. Submit the universal Ohio Association of Health Plans form to request prior authorization for outpatient behavioral health services. Ohio...
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Rights & Responsibilities
https://www.caresource.com/plans/mycare-snp/plan-documents/rights-responsibilities/...carry out your rights and know that CareSource MyCare Ohio, CareSource MyCare Ohio’s providers or the Ohio Department of Medicaid (ODM) will not hold this against you. To know that...
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Quick Reference Materials
https://www.caresource.com/providers/tools-resources/quick-reference-materials/...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...
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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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Rights & Responsibilities
https://www.caresource.com/plan-documents/rights-responsibilities/...carry out your rights and know that CareSource MyCare Ohio, CareSource MyCare Ohio’s providers or the Ohio Department of Medicaid (ODM) will not hold this against you. To know that...
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