...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...

...Urine Drug Screening Prior Authorization Form – Submit this form when requesting prior authorization for urine drug screenings Submit the SUD 1115 Waiver Universal PA Form to request prior authorization...

...Active COVID-19: Temporary Change to Prior Authorization for Transition to Post-Acute Care – UPDATE 11/05/2021 Expired COVID-19: Medicare Billing Vaccination Billing Guidance 11/04/2021 Active COVID-19: Temporary Change to Prior Authorization...

...Forms Find forms for contracting, authorization, claim submission and more. VIEW FORMS Procedure Code Lookup Tool Look up CPT and HCPCS codes to determine if prior authorization is required. Procedure...

EDUCATION SEMINARS – West Virginia Senate Bill 267 – Prior Authorizations Learn about the prior authorization changes that the West Virginia Senate Bill 267 mandates for providers and payors effective...

...not pay for a covered service performed by the provider unless CareSource PASSE denies prior authorization of the service and the provider notifies the member in writing that the member...

...information (SHI). The Member Consent/HIPAA Authorization Form can also be used to designate a person to speak on the member’s behalf. Please encourage CareSource members who have not consented to...

...which services need a prior authorization before you can get them. 2022 Prior Authorization List (Updated 10/01/2021) Usually your primary care provider (PCP) will ask for prior authorization from us...

CareSource PASSE™ follows Arkansas Medicaid’s evidence-based Prescription Drug Program, Preferred Drug List (PDL) and Prior Authorization Criteria. Search Tips: To access the downloadable Preferred Drug List and Prior Authorization Criteria...