Communicating
with CareSource
CareSource communicates with our health partner network through a variety of
channels, including phone, fax, Provider Portal, newsletters, CareSource.com
and Network Notifications.
CareSource Hours of Operation
Provider Services
Ohio Medicaid
M-F
8am-6pm
Member Services
CareSource24® (All Plans)
24/7/365
Ohio Medicaid
M-F
7am-7pm
Please visit CareSource.com for the holiday schedule or contact the Provider
Services Department for more information.
Phone
To help us direct your call to the appropriate professional for assistance, you will
be instructed to select the menu option(s) that best fits your need. Please note that
our menu options are subject to change. We also provide telephone based selfservice applications that allow you to verify member eligibility.
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Phone Numbers
Provider Services..........................................................1-800-488-0134
Prior Authorizations.......................................................1-800-488-0134
Claims Inquiries............................................................1-800-488-0134
Credentialing................................................................1-800-488-0134
Ohio Medicaid Member Services.................................1-800-488-0134
CareSource24 - Nurse Advice Line (Medicaid)............1-866-206-0554
CareSource24 - Nurse Advice Line (MyCare Ohio)......1-866-206-7861
Fraud, Waste and Abuse Hotline..................................1-800-488-0134
TTY for the Hearing Impaired.......................................1-800-750-0750 or 711
Fax Numbers
Care Management Referral...........................................1-877-946-2273
Credentialing................................................................1-866-573-0018
Contract Implementation...............................................1-937-396-3632
Fraud, Waste and Abuse..............................................1-800-418-0248
Medical Prior Authorization Form..................................1-888-752-0012
Health Partner Appeals................................................1-937-531-2398
Health Partner Maintenance (e.g., office changes,
adding/deleting health partners)................................1-937-396-3076
Website/Online Provider Portal
Accessing our website, CareSource.com, is quick and easy. On the Provider
section of the site, you will find commonly used forms, newsletters, updates and
announcements, our Health Partner Manual, claims information, frequently asked
questions, clinical and preventive guidelines and much more. Health partners can
also find information on our product lines: Ohio Medicaid, CareSource MyCare
Ohio, and Ohio Home Care Waiver and Transitions Carve Out Waiver.
Provider Portal: https://providerportal.caresource.com/OH/
Our secure online Provider Portal allows you instant access at any time to
valuable information, tools including the Member Profile and CareSource Clinical
Practice Registry, various self-service options, clinical and preventive guidelines
and other resources. Simply enter your user name and password (if already a
registered user), or submit your information to become a registered user. Assisting
you is one of our top priorities in order to deliver better health outcomes for our
members.
Provider Portal Benefits
• A secure online (encrypted) tool that allows you to easily access time-saving
services and critical information
• Available 24 hours a day, 7 days a week
•Free
• Accessible on any PC without any additional software
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Provider Portal – Value to You
We encourage you to take advantage of the following time-saving tools:
• Payment History – Search for payments by Check Number or Claim Number
• Claim Status – Search for status of claims and claim appeals
• Coordination of Benefits (COB) – Confirm COB for patients
• Prior Authorization – Medical inpatient/outpatient, home health care and
Synagis
• Eligibility Termination Dates – View the member’s termination date (if
applicable) under the eligibility tab
• Care Management Referrals – The care management form is now automated
on our Portal for efficiency in enrolling members
• Benefit Limits – Health partners can track benefit limits electronically in realtime before services are rendered for: Chiropractic, Occupational Therapy,
Physical Therapy, Speech Therapy
• Care Treatment Plans – Health partners now have the option to view care
treatment plans for their patients on our Provider Portal
• Claim History for Vision Benefits
• Monthly Membership Lists – PCPs can view and download current monthly
membership lists
• Member Profile – Comprehensive view of patient medical/pharmacy utilization
• CareSource Clinical Practice Registry – Innovative tool for PCPs that helps
easily view and sort CareSource members into actionable groups for improved
focus on preventive care (e.g., well baby visits, diabetes, asthma and more)
– Look on the “Member Eligibility” page for alerts to notify you what tests a
patient needs
Dental health partners – Please refer to the Dental Handbook or CareSource.com
for information about the Provider Portal capabilities specifically for dental health
partners.
Portal Registration
If you are not registered with CareSource’s Provider Portal, please follow these easy
steps:
1.Click on the “Register Now” button and complete the three-step registration
process. Note: you will need to have your Tax ID number.
2.Click the “Continue” button.
3.Note the username and password you create so that you can access the Portal’s
many helpful tools.
If you do not remember your username/password, please call the Provider Services
Department at 1-800-488-0134.
Communicating by Email: Provider E-Communication System
CareSource uses a health partner E-Communication System to distribute information
via email to health partners. CareSource information will be sent via email to the
health partner and/ or designated staff members. Health partners, office managers,
billing offices, and other contacts can receive information specific to their needs. This
process will help us communicate with you more efficiently and effectively, and your
office will be less cluttered with mailings that may not be relevant to you.
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In order for you to get the most out of this robust system, you will need to register
and provide updated contact information. To register:
1.Go to the CareSource website at CareSource.com.
2.Select “Providers; go to “Ohio Providers,” then select “Medicaid.”
3.Select “Register/Update Provider Email” from the “Quick Links.”
4.Follow the log-on instructions.
5.You will be asked to complete the contact information and submit your email
address.
Health partners can add multiple contacts to receive email information from
CareSource. Designate one contact as the “Primary Contact,” and identify others
as “Additional Contacts.” The Primary Contact will receive key information regarding
system administration. For example, if one of a health partner’s additional contacts
forgets their password and requests that it be reset, the reset notification will be sent
to the Primary Contact.
You will also want to identify each contact as a particular “Contact Type” to help
determine the e-mail notifications received from CareSource. For example, billing
information will be sent directly to individuals associated with a billing office. We
request that at least one individual within the office or group be identified as the
General Contact. The General Contact will receive all e-mail notifications from
CareSource.
Your health partner information can be updated at any time by going to the
“Register/ Update Provider Email” from the “Quick Links” on the health partner Web
page.
Frequently asked Questions about the health partner E-Communication
System
Q. What is the Health Partner E-communication System?
A. The CareSource health partner E-communication system provides information
electronically. This system provides targeted email to specific individuals based on
contact type. Physicians, office managers, billing offices, etc. receive information
specific to their needs.
Q. Why should I and/or my office register to receive information via email?
A. Email delivery of information will be more efficient, timely and targeted:
• The system will provide enhanced communication delivered more effectively
than print mailings or blast faxes.
• The office won’t be cluttered with mailings that may not be relevant.
• You will receive notifications rather than having to remind yourself to check the
CareSource health partner site.
• Information will be delivered when it is generated, rather than mailed at a later
date.
• You will receive information relevant to your position and interests.
Q. I don’t remember my username/password for the health partner Database.
How do I get access?
A. Your health partner ID number is your username. If you cannot remember your
password, go to the health partner E-Communication Database sign-in page and
follow the instructions for resetting your password.
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IMPORTANT NOTE – The information about resetting your password will be sent by
email to the Primary Contact for the system. If you do not know your primary contact,
inquire within your office – CareSource does not have that information.
Q. What if I register, but then decide I don’t want to receive email from
CareSource?
A. Individuals can choose to unsubscribe to email at any time by selecting the
“unsubscribe” option located on the email.
Q. I previously unsubscribed, but I would now like to receive email. What do I
do?
A. Please call Provider Services and provide your name, email address and phone
number. You will be re-subscribed to receive email. This process can take a few days
to update, so thank you for your patience.
How to Communicate with CareSource by Mail
CareSource
P.O. Box 8738
Dayton, OH 45401-8738
Health Partner Appeals Mailing Address (Medicaid/Medicare)
CareSource
P.O. Box 2008
Dayton, OH 45401-2008
Please visit our website at www.caresource.com/providers for more information on
how appeals can be submitted online.
Member Appeals & Grievances Mailing Addresses (Medicaid/Medicare)
CareSource
P.O. Box 1947
Dayton, OH 45401-1947
Medicare Pharmacy Appeals
CVS Caremark MC 109
P.O. Box 52000
Phoenix, AZ 85072-2000
Medicare Pharmacy Grievances
CareSource
Attn: Member Grievance & Appeals
P.O. Box 1947
Dayton, OH 45401-1947
Claims Mailing Addresses (Medicaid/Medicare)
CareSource
Attn: Claims Department
P.O. Box 8730
Dayton, OH 45401-8730
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Fraud, Waste and Abuse Address (Medicaid/Medicare)
CareSource
Attn: Special Investigations Department
Box 1940
Dayton, OH 45401-1940
Information reported to us can be reported anonymously and is kept confidential to
the extent permitted by law.
Newsletters
CareSource communicates with health partners in a variety of ways. Our
ProviderSource newsletter, produced three times a year, is available online and
contains operational updates, clinical articles and new initiatives underway at
CareSource. Please visit CareSource.com for the ProviderSource newsletter.
Network Notifications
Network Notifications are published for CareSource health partners to regularly
communicate updates to policies and procedures. Network Notifications are found on
the Updates/Announcements page of our website and are sent via email to registered
health partners.
Health Partner Demographic Changes and Updates
Advance written notice of status changes, such as a change in address, phone, or
adding or deleting a health partner to your practice helps us keep our records current
and are critical for claims processing.
Email: providermaintenance@caresource.com
Mail: C
areSource
Attn: Provider Maintenance
P.O. Box 8738
Dayton, OH 45401-8738
Fax:1-937-396-3076
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