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.
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 Notification 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.
RSV season is about to begin. Providers can access guidelines for the 2013-2014 season here.
CareSource is returning to its former Coordination of Benefits (COB) policy. In June of 2012, we revised our COB policy in an effort to encourage more HEDIS-related claim submissions from providers. However, these goals were not met, and the cost of the change far exceeded our expectations. As good stewards of tax payer dollars, we are reverting to our former COB policy effective Nov. 5, 2012. Learn more at our Network Notification and FAQs.
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.
Are you treating a CareSource Member for Fibromyalgia? CareSource Pharmacy wants you to have the latest information comparing medication costs. Access a fax blast outlining those differences here. Watch for additional fax blasts with cost comparisons for other medications every few weeks. Thank you for the care you provide to our CareSource Members.
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.
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.
ODM ICD-10 Q&As
The Ohio Department of Medicaid, in collaboration with Ohio's Medicaid Managed Care Plans, has developed ICD-10 Ohio Medicaid Provider Q&As. 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: