Updates & Announcements

We strive to make partnering with us simple. We’re aware things may change in the way we do business with you and want to communicate these changes to you in an efficient manner.

Visit this page frequently to find all the latest CareSource news. We share updates regarding:

  • Pharmacy information, including our Preferred Drug Lists (PDLs)
  • Medical, pharmacy, reimbursement, and administrative policies policies
  • Authorization requirements as communicated through network notifications below

Note: The links below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

General Updates

2025Date
Navigate Policy Updates December 202512/01/2025
Navigate Policy Updates November 202511/01/2025
Navigate Claims Editing - Add-On Codes, E/M and Special Services10/15/2025
Navigate Lymphedema Compression Treatment Items Claims Editing Enhancements10/15/2025
Navigate Claim Edits for Durable Medical Equipment10/15/2025
Navigate New Claim Condition Code Requirements10/15/2025
Navigate Newborn RSV Prevention10/15/2025
Navigate Policy Updates October 202510/01/2025
Navigate Provider Manual Addendum10/01/2025
Navigate Coding for Depression Screening & Follow-up (HEDIS DSF-E)09/04/2025
Navigate Policy Updates September 202509/01/2025
Navigate CGHC Edifecs CRA Solution08/25/2025
Navigate Follow-up After Hospitalization for Mental Illness (FUH) Measure Update08/15/2025
Navigate Policy Updates August 202508/01/2025
Navigate Policy Updates July 202507/01/2025
Navigate Coding Documentation Guides Available06/17/2025
Navigate Billing Update06/06/2025
Navigate Policy Updates June 202506/01/2025
Navigate Pharmacy Policy Updates May 202505/15/2025
Navigate Pharmacy Policy Updates May 202505/09/2025
Navigate Policy Updates May 202505/01/2025
Navigate Prothesis and Orthosis Claims Editing Logic04/22/2025
Navigate Cardiac and Musculoskeletal Surgical Quality and Safety Management Program in Partnership with TurningPoint – Revision04/21/2025
Navigate Policy Updates April 202504/01/2025
Navigate Pharmacy Policy Updates March 202503/01/2025
Navigate Policy Updates March 202503/01/2025
Navigate Pharmacy Policy Updates February 202502/17/2025
Navigate Policy Updates February 202502/01/2025
Navigate Availity Partnership01/01/2025
Navigate New Address for Refund Checks01/01/2025
2024Date
Navigate Pharmacy Policy Update - Bimzelx - December 202412/20/2024
Navigate Evolent (formerly National Imaging Associates, Inc.) – Revision12/10/2024
Navigate Policy Updates December 202412/01/2024
Navigate November 2024 WI MP Policy Update - Retrospective Authorization Review (AD-1464)11/22/2024
Navigate November 2024 Policy Updates11/15/2024
Navigate Inpatient Hospital Pre-payment Claims Reviews and High Dollar Claims11/14/2024
Navigate Evolent Policy Updates11/01/2024
Navigate Evolent (formerly National Imaging Associates, Inc.)10/15/2024
Navigate Cardiac and Musculoskeletal Surgical Quality and Safety Management Program10/15/2024
Navigate Policy Updates October 202410/15/2024
Navigate TurningPoint Policy Updates - October 202410/15/2024
Navigate Evolent Policy Updates October 202410/15/2024