...on when a prior authorization is required. You can also review our prior authorization list. Supplemental Benefits For 2026, CareSource Marketplace Plans feature the following supplemental benefits: TruHearing® provider network...

...planning or emergency services, out-of-network health care providers need prior authorization (also called pre-approval). Go to www.caresource.com/in/plans/medicaid/benefits-services/referrals-prior-authorization/ for more details on prior authorization. Office Visits / Hospital Type of Service...

...and preventive services do not need prior authorization. Many of these other services do require prior authorization. Call Member Services at 1-844-607-2829 (TTY: 711) to learn more. Dental Cleanings Yes...

...1, 2026 12/01/2025 Summary of Formulary/Prior Authorization Changes Effective October 1, 2025 09/01/2025 Summary of Formulary/Prior Authorization Changes Effective July 1, 2025 06/01/2025 Summary of Formulary/Prior Authorization Changes Effective April...

...form to evaluate scaling and root planning. ODJFS Dental Services Prior Authorization Form Submit this form to the Ohio Department of Job and Family Services (ODJFS) to request prior authorization...

...absence of scientific evidence, the guidelines will be determined by board-certified practitioners from appropriate specialties. CareSource submits to DCH for review and prior approval and as updated thereafter all clinical...

...a CareSource provider, you can easily access members’ benefits to best serve their needs. Prior Authorization Pharmacy Planning for Healthy Babies® Member Handbook Quality Improvement CareSource continually assesses the quality...

...Authorization Changes Effective July 1, 2025 06/01/2025 Summary of Formulary/Prior Authorization Changes Effective April 1, 2025 03/01/2025 Summary of Formulary/Prior Authorization Changes Effective January 1, 2025 12/01/2024 Summary of Formulary/Prior...

...and clinical practice guidelines to help inform and guide the provision of clinical care to members. CPGs are identified through member review of member population demographics and state/national priorities. Review...

...A One Front Door approach has been established to simplify the submission of claims and prior authorizations. Submitting Claims and Authorizations Providers can submit claims and prior authorizations in two...