The Provider Portal makes it easier for you to work with us 24/7. It has critical information and tools to save your practice time. This helpful online tool is available for all CareSource Ohio plans.
If you are not already registered for the Provider Portal, please register here. You can refer to the Portal Registration Training Module for step-by-step instructions.
If you have a login but cannot remember your username and/or password, please call the CareSource Provider Services Department at 1-800-488-0134.
Cut down on clutter and go green! Register for CareSource Provider E-Communication System and receive relevant and timely information via email. Please register here.
With the transition to ICD-10 now just a few months away, your Health Partnership Team would like to gauge your needs and readiness to code claims using the ICD-10 codes beginning October 1, 2015. Please take a few minutes to complete our short, five-question survey. It should take about five minutes. Thank you for your help!
Health partners can now submit claims through the secure Provider Portal using our online claim forms. Online submission saves you money by eliminating the costs associated with paper claims. In addition, CareSource offers this submission method via our Provider Portal at no cost. To learn more, please read "Submit Claims Online Through Provider Portal." CareSource® Medicaid and CareSource® MyCare Ohio (Medicare-Medicaid Plan) providers, please click here. CareSource Just4Me™ providers, please click here.
Health partners now have a new tool to request prior authorizations for some procedures. Use the Cite® Auto Auth tool to input clinical details and receive a decision in just seconds! Learn more with our Network Notification.
Effective May 4, 2015, CareSource is implementing a policy change requiring prior authorization for some interventional pain management procedures and CPAPs for dates of service beginning May 4, 2015. For more information, please read our Network Notification.
As part of the Patient Protection and Affordable Care Act (ACA), the Primary Care Physician Rate Increases (PCRI) ended at the conclusion of calendar year 2014. This means that the federal government will no longer be financing the difference between the state Medicaid payment rate and the applicable Medicare rate.
To receive payment inclusive of the rate increase, all eligible claims for PCRI must be clean and submitted to CareSource by May 1, 2015.
You can find more information on PCRI at the Ohio Department of Medicaid website.
If you are unable to log in to the Provider Portal and access your service plan, use this form to expedite your claims payment. Click here for instructions to complete the form and for a list of valid service codes. After you complete the paper claim form, you may either mail it or fax it for processing:
CareSourceAttn: Claims DepartmentP.O. Box 8730Dayton, OH 45401-8730Fax: 937-224-3388
You will use this paper claim process until you can log in to the Provider Portal and access your service plan. For training on the Provider Portal claims submission process, access the training module below. The MyCare Ohio Provider Portal User Guide provides instructions to log in to the portal and submit claims.
To ensure that we have the most up-to-date service plan for our MyCare members, please fax your service plan to 937-487-0936. This number is only for service plans and NOT claims submissions.
The attached training module provides an overview of the CareSource® MyCare Ohio Service Plan and Claims Submission. Please review the material for a quick training session!