If you are not already registered for the Provider Portal, please register here.
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.
ICD-10 Implementation Delayed to October 1, 2015
Federal legislation recently passed has delayed the implementation of new ICD-10 codes to October 1, 2015. Read more.
Integrated Behavioral Health: SBIRT
Ohio Medicaid now covers a group of services aimed at early detection of health risk behaviors associated with alcohol or drug consumption to prevent abuse, dependence and the need for more extensive treatment. Screening, Brief Intervention, and Referral to Treatment (SBIRT) services that are medically reasonable and necessary can now be rendered by eligible providers. See the Network Notiication located on the Provider section of CareSource.com for more details.
New Payment Policies Page
CareSource is pleased to announce the addition of a Payment Policies page to CareSource.com. We hope this new tool will help reduce time spent searching for payment policies. For more information, please view the related Network Notification.
At CareSource, we want to ensure our members receive the best possible care. Protecting our members’ privacy is our number one priority. To ensure compliance with federal regulations related to the confidentiality of drug and/or alcohol treatment, we are asking Health Home Providers to obtain consent from the patient in order to share their care treatment plan with us. Thank you for your continued support.
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!
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.
Fee Schedule Resources and Links
We value our health partners and want to make it easier for you to get the information you need, including fee schedules. The Centers for Medicare & Medicaid Services (CMS) provide links to fee schedules and instructions for using them. Please use our Network Notification as a guide for accessing information regarding fee schedules.
NPI Claims Requirements
Effective May 1, 2014 all claims must include the correct Rendering National Provider Identifier (NPI) or they will be rejected. This pertains to both EDI 837 transactions and paper forms. Refer to the network notification for complete details.
New CMS-1500 Claim Form
The CMS-1500 Claim Form has been recently revised with changes including those to more adequately support the use of the ICD-10 diagnosis code set. The revised CMS-1500 form (version 02/12) will replace version 08/05. To assist our providers, CareSource will accept both forms, effective January 6, 2014. Read more.
Online Drug Formulary Search Tool Available
CareSource has a new, easy to use online drug formulary tool that can help you save time by quickly looking up medications to make sure they are covered by CareSource. Also, you can check for generic alternatives, prior authorization requirements, and any restrictions or limits that may apply. To start using the tool, visit our Medicaid Pharmacy Searchable Drug Formulary web page.
Advance written notice of status changes, such as a change in address, phone, or adding or deleting a provider to your practice help us keep our records current and are critical for claims processing. Please complete the Provider/Group Change Request Form and submit to CareSource: