...part of prior reviews or decisions. Please call Member Services if you are not happy with our decision. You also have the right to file a complaint at any time...

...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...

...You should get urgent care from the nearest and most appropriate health care provider. Emergency care is covered both in and out of our service area. Prior to seeking urgent...

...community. With a proven track record of leadership and innovation Holly brings decades of experience in the defense and health information technology sectors to this role. Prior to this role,...

...will not pay for claims for dates of service prior to the credentialing approval date. Contracting Upon a provider’s interest in contracting with CareSource, the process below is followed: CareSource...

At CareSource, we bring true partnership to Georgia providers. As part of our network, you can expect accurate claims processing, efficient prior authorizations and the dedicated commitment of a nonprofit...

...need prior approval Member Responsibilities As a member of our health plan you must also be sure to: Review your HAP CareSource member materials Make and keep appointments with your...

...is important to verify beneficiary eligibility using their Beneficiary ID card and our provider portal prior to each service rendered. We recommend that you check member eligibility each and every...

...Health Equity Accreditation provides an actionable framework for helping health systems continuously improve—and prioritize—health equity for the members and communities we serve. NCQA LONG-TERM SERVICES AND SUPPORTS (LTSS) DESTINCTION Michigan...

...And so much more! *Some services need to be approved before you can get them. This is called prior authorization (pre-authorization). It must be medically necessary for your care. Your...