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False Claims Act
https://www.caresource.com/providers/education/fraud-waste-abuse/false-claims-act/...through programs, agencies or contracts. The False Claims Act applies when a company or person: Knowingly presents a false or fraudulent claim for payment, Knowingly uses a false record or...
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Patient Administration
https://www.caresource.com/providers/education/patient-care/patient-administration/...their premium payment. CareSource will continue to process medical claims and pay providers during this grace period. After 30 days of nonpayment, the member’s eligibility will be flagged as delinquent...
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Check Eligibility
https://www.caresource.com/providers/provider-portal/check-eligibility/...the grace period, if the member is terminated due to non-payment of premium, CareSource will recoup any payments made for claims received in the second and third months of the...
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Fraud, Waste and Abuse (FWA)
https://www.caresource.com/about-us/legal/corporate-compliance/vendor-compliance/fraud-waste-and-abuse-fwa/...rendered Retaining payments made in error by CareSource Payments stemming from kickbacks or Federal Stark Law violations Duplicate payments for services Member: Inappropriate use of Medicaid/Medicare purchased narcotics Forging prescriptions...
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Welcome
https://www.caresource.com/providers/welcome/Welcome to CareSource PASSE Our mission is: Putting Members First, Pursuing Better Health Care. Together we can make a lasting difference in the lives of those we serve by improving...
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Forms
https://www.caresource.com/providers/tools-resources/forms/...Form Mail your refund check, this form and any other required documentation to HAP CareSource. Overpayment Recovery Form Submit this form to offset overpaid claims against a future payment. Itemized...
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How to Get Help with Drug Costs
https://www.caresource.com/plans/dsnp/pharmacy/drug-cost-help/...you in the amount of your overpayment, or we will offset future copayments. If the pharmacy hasn’t collected a copayment from you and is carrying your copayment as a debt...
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Claim Rejection Notifications
https://www.caresource.com/providers/provider-portal/claims/claim-rejection-notifications/...to Fix: Correct DOS with date after ICD-10 was available. Error Number: 766 Error Description: Services were performed during a Health Insurance Exchange (HIX) premium payment grace period. Error Number:...
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Provider Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/CareSource maintains medical, payment and administrative policies for our health partners. These policies are regularly reviewed, updated, withdrawn or added; and therefore, subject to change. The policies presented on these...
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Open Enrollment Deadlines
https://www.caresource.com/plans/marketplace/open-enrollment-deadlines/...25th of each month before the start of the coverage month. For example, pay by February 25 for your March coverage. What Payment Options Are Available? We accept payments online,...
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