...Canals Routine Tooth Extractions Surgical Extractions* & Other Oral Surgery * Approval or prior authorization required. We cover routine eye exams and eyewear. If you are under the age of...

...the new calendar year, such as prior authorization or step therapy requirements. You can get a transition refill up to 90 days after enrolling in a new plan or after...

...use disorder (SUD) care need prior authorization (PA). If you need partial hospitalization, Intensive Outpatient Treatment and other special outpatient care, home-based care and more, you will need a PA...

...scope The HL7 FHIR (Fast Healthcare Interoperability Resource) standard is used for patient and publicly available provider data Smart on FHIR is utilized for authorization flows related to member authorization...

...role of CANS in determining OhioRISE eligibility. This flier can be distributed by CANS assessors prior to or at the time of a CANS assessment. Care Coordination Portal Access Training...

Thank you for choosing us! We want you to be happy with your coverage. We offer a suite of online self-service tools, but you can always call Member Services with...

We make it easy for you to request services for your patients. See below for benefit information and instructions to obtain services that enable improved access to care. 9-8-8 Suicide...

We are excited to welcome you as a CareSource member and introduce some of the programs and tools that make CareSource more than just health insurance. We are Health Care...

...you know we got your appeal. The people making appeal decisions are not part of prior reviews or decision making. They are health care professionals. They are supervised by our...

These medical policies apply to the CareSource plan. Medical policies offer guidance on determination of medical necessity and appropriateness of care for approved benefits. Benefit determinations and coverage decisions are...