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LGBTQ+ Health Care Resources
https://www.caresource.com/members/education/lgbtq-resources/...our endorsement. Finding Care and Your Rights Find Providers Find LGBTQ+ affirming providers. They know and understand the needs of LGBTQ+ people. Not all the providers listed are in our...
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Forms
https://www.caresource.com/providers/tools-resources/forms/...Standards for Practitioners and Providers Below, you’ll find essential forms and documents providers need to best serve our members. Note: You may need to download Adobe Acrobat Reader to open...
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Behavioral Health
https://www.caresource.com/providers/education/patient-care/behavioral-health/...care they need. Coordinating Integrated Care Coordinated care is key to ensuring optimal outcomes for our members. We ensure our providers have access to behavioral health resources and that behavioral...
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Quick Start Guide
https://www.caresource.com/members/tools-resources/quick-start-guide/...nurses through our 24-Hour Nurse Advice Line. No-cost, 24-hour telehealth care providers through Teladoc®. No-cost telehealth mental health and substance use disorder counseling through Teladoc, 7 a.m. to 9 p.m....
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Fraud, Waste & Abuse
https://www.caresource.com/members/tools-resources/fraud-waste-abuse/...Like? Health care fraud, waste and abuse can be committed by health providers, members or pharmacies. Examples include the following. Health partners who: Providers who: Order medications, equipment or services...
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Claim Rejection Notifications
https://www.caresource.com/providers/provider-portal/claims/claim-rejection-notifications/...at 1-800-488-0134 or visit https://www.caresource.com/providers/ for instructions. Error Number: 132 Error Description: Missing/Invalid Medicaid ID for Atypical Provider How to Fix: Ensure correct Medicaid ID is provided. Error Number: 187...
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Provider Responsibilities
https://www.caresource.com/providers/education/health-equity/provider-responsibilities/Providers are expected to deliver services in a culturally competent manner, which includes removing all language barriers, accommodating the unique ethnic, cultural and social needs of the member and understand...
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Non-Participating Provider Appeals & Disputes
https://www.caresource.com/providers/provider-portal/appeals/non-participating-provider-appeals-disputes/...non-contracted providers as Medicare would have paid for the same service. Non-contracted providers have the right to request a reconsideration of the plan’s denial of payment: Non-contracted providers have 60...
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Patient Administration
https://www.caresource.com/providers/education/patient-care/patient-administration/...Providers may not charge members for services which CareSource PASSE™ denied based on lack of medical necessity or lack of compliance to contractual terms. Providers may not bill members for...
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Quality Improvement Program
https://www.caresource.com/members/tools-resources/quality-improvement/qip/...Excellent Accreditation Compliance with NCQA accreditation standards High level of Healthcare Effectiveness Data and Information Set (HEDIS®) performance High level of Consumer Assessment of Healthcare Providers and Systems (CAHPS®) performance...
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