...to verify procedures and payment mechanisms are compliant. Our proactive monitoring includes prepay review edits, prior authorization monitoring, analytic performance dashboard monitoring, and verification of services. Our reactive monitoring includes...

...you are either (i) the individual to whom this account pertains, or (ii) legally authorized under applicable law to receive health care information regarding, and to make health care decisions...

Provider Attestation Form – Submit this form to attest to practice competency prior to working with CareSource. CCVS Provider Authorization and Release Form – Submit this form to authorize release...

...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...

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...

The frequently asked questions below are intended to help First Tier, Downstream and Related Entities (FDR) understand and manage their compliance efforts. Please click on the expandable menus below to...

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...

...exam, cleaning, fluoride treatments and dental implants. *Prior Authorization required. Vision Benefits No cost routine eye exam. Routine Exam, Eyeglasses are covered: Age 21-59 – 1 pair every 2 years;...

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...

At TrueCare, we are more than just quality health insurance. We care about YOU. We know that life can be hectic. Making your health and wellness a priority can be...