...Demo. Utilization Management – View our utilization management activities including prior authorization, concurrent review, discharge planning and other activities. Tobacco and Vaping Cessation Tool Kit – Access our tools and...

...(prior authorization) in order for it to be covered by your plan. The health partner who orders the drug should help you get a prior authorization. The prior authorization requirements...

...submit a request for a prior authorization using this form. A list of services that require Prior Authorization is available on the Plan Documents page. We want you to easily...

The Public Health Emergency (PHE) for COVID-19 has ended. Services like vaccines, treatment, and testing are still available. Some rules changed, stopped, or started again. CareSource continues to watch COVID-19...

...or our providers, you or your authorized representative can let us know. In order for CareSource to talk to your authorized representative, you and your authorized representative must complete the...

...a link between your office and CareSource. It provides important information on topics such as covered services, services that require prior authorization, claim submission, and more. View the Dental Provider...

...receipt of a pharmacy prior authorization request. If it is an emergency, a 72-hour override may be used so that you can get your medicine. Prior authorization requests for a...

...needs and taking appropriate action Providing phone coverage for handling patients’ calls 24/7 Following all referral and prior authorization policies and procedures as outlined in the Provider Manual Complying with...

...scheduled. If you have questions about the prior authorization process or status, please call Member Services. Your provider can submit a request for a prior authorization using the Prior Authorization...

...called Multi-Factor Authentication (MFA), and this process will be implemented for all new and existing users who register and log in to the Provider Portal. This page explains what it...