...West Virginia Health Coverage Programs and CareSource require that you submit your National Provider Identifier (NPI) number to CareSource along withthe completed West Virginia uniform credentialing and recredentialing form.Also complete...

...a prior authorization using the Prior Authorization Request Form (coming soon). If you are seeing a specialist, they will get approval from your primary care provider (PCP). Pharmacy Documents List...

...for claims, prior authorizations, and other administrative tasks for providers. Submitting Claims and Authorizations ODM is implementing a One Front Door approach to streamline claim and prior authorization submissions. Providers...

...The Prior Authorization List shows which services need a prior authorization before you can get them. 2022 Prior Authorization List (for Ohio only) 2021 Prior Authorization List Usually your primary...

...We are open 9 a.m. to 5:30 p.m. Monday through Friday. Comprehensive Drug Formulary CareSource MyCare Ohio uses a Comprehensive Formulary. The list shows the drugs we want your primary...

...Hospital Interim Billing Inpatient Prior Authorization/Precertification Independent Provider Q&A Delivery and Gestation Diagnosis Codes ICD-10 Resource Center ICD-10 Health Partner Readiness Webinar Slides Network Notifications Frequently Asked Questions Centers for...

...initially prescribed. 2026 Step Therapy Criteria Prior Authorization Criteria For certain drugs, your prescriber will need to contact us before you can fill your prescription. Prior Authorization Criteria Visit the...

...Prior Authorizations Some prescriptions may need a prior authorization. This means that it will need to be reviewed and approved by us before you can fill it. Your provider will...

...home. Quantity limits and prior authorizations are waived. This includes: Replacements if equipment is lost or damaged. Medical supplies such as diabetic supplies, incontinence supplies and enteral formula. Face masks,...

...medical practice and are the lowest cost alternative for the member. These requirements ensure appropriate use of these medications. Drug Formulary Pharmacy Policies Pharmacy Forms Prior Authorization Pharmacy Benefit Manager...