Past 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 the Updates & Announcements 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
  • Authorization requirements as communicated through network notifications below 

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

Navigate Pharmacy Policy Updates-January 202312/09/2022
Navigate Policy Updates December 202212/01/2022
Navigate Provider Alternative Format Request11/10/2022
Navigate CareSource and TurningPoint Partnership for Cardiac and Musculoskeletal Surgical Procedures11/1/2022
Navigate Policy Updates November 202211/1/2022
Navigate Updated Prior Authorization List10/31/2022
Navigate Policy Updates October 202210/01/2022
Navigate Quarter 2 Avalon Medical Policy Update10/01/2022
Navigate Marketplace Member Grace Period & Termination Notice09/15/2022
Navigate Pharmacy Policy Updates - October 202209/12/2022
Navigate CLIA-Waived Tests Update09/01/2022
Navigate Policy Updates September 202209/01/2022
Navigate Billing Update: Incorrect Billing of Modifier 58 Notification08/24/2022
Navigate Billing Update Re: Multiple Outpatient Claims08/17/2022
Navigate Quarter 1 2022 Avalon Medical Policy Update08/01/2022
Navigate Policy Updates August 202208/01/2022
Navigate How to Close Diabetes Care Gaps & Receive Bonus Payments in 202207/20/2022
Navigate Policy Updates July 202207/01/2022
Navigate Pharmacy Policy Updates - July 202207/01/2022
Navigate Quarter 3 & 4 Avalon Medical Policy Update06/30/2022
Navigate We Want to Hear from You!06/28/2022
Navigate Upload Claim Submissions Seamlessly in Provider Portal06/01/2022
Navigate Policy Updates June 202206/01/2022
Navigate Quarter 2 Avalon Medical Policy Update05/31/2022
Navigate Quarter 2 Avalon Reimbursement Policy Update05/31/2022
Navigate Policy Updates - May 202205/01/2022
Navigate Billing Updates: Chiropractic Unbundling04/26/2022
Navigate Policy Updates - April 202204/01/2022
Navigate Billing Update: Medicare Bundled Services04/01/2022
Navigate Pharmacy Policy Updates - April 202204/01/2022
Navigate Billing Updates: Duplicate Discharge Day Management/ICD-10 7th Character and Therapy Proposal04/01/2022
Navigate Introducing Teladoc, CareSource’s New Telehealth Partner03/29/2022
Navigate Billing Updates: EDCf Evaluation & Management Policy03/25/2022
Navigate Quality Patient Experience Guide (CAHPS resource)03/18/2022
Navigate Retro Authorization Submission Guidelines03/15/2022 
Navigate Policy Updates March 202203/01/2022 
Navigate Provider Portal Account Linking Enhancement02/21/2022
Navigate No Surprises Act Update01/24/2022
Navigate Prior Authorization Requirement Updates01/14/2022
Navigate Correct Coding Claims Update01/11/2022
Navigate UPDATE – Laboratory Benefit Management Program for Genetic Testing Management Implementation01/05/2022
Navigate Policy Updates January 202201/01/2022
Navigate 2021 Quarter 3 Provider Portal Updates12/31/2021
Navigate Prior Authorization Requirement for Non-Participating Laboratory Services12/10/2021
Navigate Policy Updates December 202112/01/2021
Navigate New Laboratory Benefit Management Program12/01/2021
Navigate HEDIS Measure Update11/10/2021
Navigate 2021-2022 Respiratory Syncytial Virus (RSV) Season and Synagis® Criteria11/02/2021
Navigate Policy Updates November 202111/01/2021
Navigate Marketplace Opioid Treatment Program Coverage10/25/2021
Navigate HIPAA CORE Compliant Codes10/08/2021
Navigate Policy Updates October 202110/01/2021
Navigate RSV Prevalence Alert in Young Children09/23/2021
Navigate Marketplace Member Grace Period & Termination Notice09/10/2021
Navigate Policy Updates September 202109/01/2021
Navigate Policy Updates August 202108/01/2021
New NCQA® Kidney Health Measure – Notification removed as this is not a required measure for Marketplace in 2021.07/28/2021
Navigate Pharmacy Prior Authorization Provider Portal Enhancement07/12/2021
Navigate Policy Updates July 202107/01/2021
Navigate CMS Interoperability06/22/2021
Navigate Q4 2020 Provider Portal Updates06/21/2021
Navigate CareSource's Care Management Program06/14/2021
Navigate We Want to Hear From You!06/07/2021
Navigate Policy Updates June 202106/01/2021
Navigate Utilization Management Process05/18/2021
Navigate Provider Portal Enhancements05/05/2021
Navigate Policy Updates May 202105/01/2021
Navigate Policy Updates April 202104/01/2021
Navigate Policy Updates March 202103/01/2021
Navigate Equian Process Frequently Asked Questions02/26/2021
Navigate Cotiviti Payment Enhancement02/12/2021
Navigate Policy Updates February 202102/01/2021
Navigate SolarWinds Cyberattack01/08/2021
Navigate Elective Transplant Process Change01/08/2021
Navigate UPDATE- Prior Authorization Requirements01/06/2021
Navigate Policy Updates January 202101/01/2021
Navigate Introducing New Prior Authorization Procedure Code Look-Up Tool12/17/2020
Navigate Register With Dental Partner DentaQuest - Reminder12/17/2020
Navigate 2021 Prior Authorization List Reminder12/01/2020
Navigate Policy Updates December 202012/01/2020
Navigate Register with CareSource’s Payment Partner ECHO Health11/23/2020
Navigate 2020-2021 Respiratory Syncytial Virus (RSV) Season and Synagis® Criteria11/23/2020
Navigate CareSource Cultural Competency Training11/17/2020
Navigate Policy Updates November 202011/01/2020
Navigate Home Health Value Code Requirement10/26/2020
Navigate Updates to Marketplace Prior Authorization List10/19/2020
Navigate 2020 Quarter 2 Provider Portal Updates10/15/2020
Navigate DentaQuest to Administer Marketplace Exchange Dental Benefits10/02/2020
Navigate Policy Updates October 202010/01/2020
Navigate Claim Payment Advice (835) Enhancements09/23/2020
Navigate Enhanced Claim Editing Implementation09/21/2020
Navigate Postpartum Visit HEDIS Update09/09/2020
Navigate Risk Adjustment Coding Education09/08/2020
Navigate Claim Remittance Delay09/03/2020
Navigate Policy Updates September 202009/01/2020
Navigate Provider Portal Claims Quick Start Guide08/13/2020
Navigate Provider Directory Information Attestation08/04/2020
Navigate Policy Updates August 202008/01/2020
Navigate Enhancements to Prior Authorizations on Provider PortalUPDATE07/27/2020
Navigate Policy Updates July 202007/01/2020
Navigate Interactive Voice Response (IVR) Enhancements for Providers06/25/2020
Navigate Provider Portal Claims Submittal Enhancement06/15/2020
Navigate Policy Updates June 202006/01/2020
Navigate Holiday Claim Remittance Delays05/19/2020
Navigate Risk Adjustment Education05/14/2020
Navigate Provider Portal Claims Attachment Quick Start Guide05/07/2020
Navigate Policy Updates May 202005/01/2020
Navigate Designation of Availity as Exclusive EDI Gateway04/15/2020
Navigate Policy Updates April 202004/01/2020
Navigate Recent Provider Portal Updates03/30/2020
Navigate Issue Resolution: Electronic Remittance Advice (ERA) PLB and Claim Level Adjustments03/13/2020
Navigate Policy Updates March 202003/01/2020
Navigate Provider Dispute ProcessUPDATE02/19/2020
Navigate Instructions on Attaching Medical Records in Provider Portal02/07/2020
Navigate Policy Updates February 202002/01/2020
Navigate Recent Provider Portal Updates01/31/2020
Navigate Paper Checks Dated 1/21, 1/22, 1/2301/27/2020
Navigate Policy Updates January 2020UPDATE01/22/2020
Navigate Provider Payment Migration Complete01/13/2020
Navigate High Dollar Claims Cover SheetUPDATE01/07/2020
Navigate Closing Quality Gaps in Care01/02/2020
Policy Updates January 2020 – This notification has been revised. See notification dated 01/22/2020.01/01/2020
Navigate Holiday Checkwrite Schedule12/26/2019
Navigate Updates to Marketplace Prior Authorization List12/09/2019
Navigate Registration Deadline Extended Again to December 13 for ECHO HealthUPDATE12/02/2019
Navigate Policy Updates December 201912/01/2019
Navigate Policy Updates November 201911/01/2019
Navigate Diabetes A1c Testing Bonus Payments10/24/2019
Navigate Registration Deadline Extended to October 18 for ECHO HealthThis notification has been revised. See notification dated 12/02/201910/08/2019
Navigate Policy Updates October 201910/01/2019
Navigate Recent Provider Portal Updates – UPDATED 10/309/23/2019
Navigate Claim Timely Filing and Appeals Timeframes09/20/2019
Navigate Enhancements to Prior Authorization on Provider Portal – This notification has been revised. See notification dated 07/27/2020.09/05/2019
Navigate Policy Updates September 201909/01/2019
Navigate Facility Claim Cost Share08/01/2019
Navigate Policy Updates August 201908/01/2019
Navigate Site of Care Transition Notice08/01/2019
Navigate Coordination of Benefits (COB) Reminder07/22/2019
Navigate Duplicate Modifier on the Claim Service Line07/17/2019
Navigate Provider Dispute ProcessThis notification has been revised. See notification dated 02/19/2020.07/05/2019
Navigate Policy Updates July 201907/01/2019
Navigate Multi-Factor Authentication Scheduled for SKYGEN CWP06/21/2019
Navigate HEDIS: Initiation and Engagement of Alcohol and other Drug Dependence Treatment (IET) Measure06/13/2019
Navigate Prior Authorization Enhancements for Observation Stays06/13/2019
Navigate How to Close Diabetes Care Gaps and Receive Bonus Payments in 201906/05/2019
Navigate Register with New Payment Partner ECHO Health by August 5This notification has been updated. Please see the notification dated 10/08/1906/04/2019
Navigate Inpatient Hospital Pre-payment Claims Reviews - Revised 6/6/201906/03/2019
Navigate Updates to Marketplace Prior Authorization List05/31/2019
Navigate Policy Updates June 201905/31/2019
Navigate Policy Updates May 201905/01/2019
Navigate Update to Emergency Room Cost Share Application04/01/2019
Navigate Policy Updates April 201904/01/2019
Navigate Enhancements to Delivery and Newborn Notifications – UPDATE03/28/2019
Navigate Interventions to Prevent Perinatal Depression03/13/2019
Navigate Policy Update May 201903/01/2019
Navigate High Dollar Claims – This notification has been revised. See notification dated 01/07/202002/19/2019 
Navigate Place of Service Code for Claim Submissions02/14/2019
Navigate Enhancements to Delivery and Newborn Notifications02/01/2019
Navigate Policy Updates March 201912/31/2018
Navigate Notice of Changes to Retro Prior Authorization Timeframe Requirements12/26/2018
Navigate Policy Updates January 201911/30/2018
Navigate Policy Updates January 201911/01/2018
Navigate Code Advisor Network Notification10/23/2018
Navigate Duplicate Claim Processing Update09/01/2018
Navigate Well-Child Care08/27/2018
Navigate Policy Updates November 201808/27/2018
Navigate Consent to Share Sensitive Health Information08/08/2018
Navigate Clarification of Indiana Network Closure Communication07/30/2018
Navigate Policy Updates October 201807/27/2018
Navigate New Address for Refund Checks07/03/2018
Navigate Policy Updates September 201806/29/2018
Navigate Notification of Claim Adjustments for Certain Edit Codes06/13/2018
Navigate Policy Updates August 201806/12/2018
Navigate Breast Imaging Reimbursement Policy06/05/2018
Navigate CareSource secure email portal security enhancements05/17/2018
Navigate Policy Updates May 201803/29/2018
Navigate Update to Provider Billing Address Requirements on Claims03/29/2018
Navigate Update to Drug Testing Policy03/12/2018
Navigate Policy Updates April 201802/27/2018
Navigate Policy Updates March 201802/01/2018
Navigate Exchange of Information Checklist01/29/2018
Navigate Diabetes Retinal Eye Exam01/25/2018
Navigate Policies Effective January 2018 West Virginia MP12/01/2017
Navigate Notice of Change to Cardiac Services Prior Authorization Requirements11/17/2017
Navigate Drug Screening Tests Reimbursement Policy – UPDATE08/31/2017
Navigate Blood Lead Testing Recommendations07/05/2017
Navigate PY-0108, PY-0109 Telemedicine-Telehealth Payment Policy05/04/2017
Navigate Health Partner Manual Addition & Revisions - Access Standards04/26/2017
Navigate PY-0037, PY-0205 Sexually Transmitted Infections Reimbursement Policy04/19/2017
Navigate Screening and Surveillance for Colorectal Cancer04/18/2017
Navigate MM-0034, MM-0079, MM-0080 Gender Dysphoria Medical Policy04/14/2017
Navigate PY-0206 Hepatitis Panel Payment Policy04/13/2017
Navigate Cite AutoAuth – Inpatient PA Requests04/03/2017
Navigate PY-0089 - Drug Screening Payment Policy – This notification has been revised. See notification dated 08/31/2017. 03/20/2017