...the unique individual needs of beneficiaries and understand that health-related social needs are significant contributors to beneficiaries outcomes and quality of life. We adhere to the National Culturally & Linguistically...

...Executive Summary The American Heart Association, American College of Cardiology, American Association of Cardiovascular & Pulmonary Rehabilitation, American Academy of Physician Assistants, Association of Black Cardiologists, American College of Preventive...

...the phone or on the internet. Watch out for people trying to offer you money or other free items for your personal information. Beware of any offers for free services...

...not treat you fairly. You are not satisfied with the quality of care you received. We will send you a letter telling you the outcome of the complaint review. If...

...may request authorization by one of the following mechanisms: Online submission Form for office use English | Spanish Written request via fax: 1-877-251-5896 for oral medications and injectable/specialty medications Toll-free...

...an overall cost for services. Overall cost considers the place (ER, office, clinic) and the cost of working with the provider. This has a high impact on the cost of...

...Members may pay a small part of their prescription costs. This is called a copayment or copay. Learn more about pharmacy copays.Learn more about pharmacy copays. Georgia Pathways to Coverage...

...Section 9 your Evidence of Coverage for timeframes for CareSource’s review of appeals and expedited appeals. Internal Appeal of Adverse Benefit Determination A decision we make about your coverage or...

...a physician’s medical judgment about individual patients. CareSource of North Carolina Co. defaults to all applicable state and federal guidelines regarding criteria for authorization of covered services. CareSource of North...

...of our health plan and the Ohio Department of Medicaid (ODM) as outlined in this manual. Providing 30 days of emergency coverage to any CareSource patient dismissed from the practice....