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  • Health Partner Change Request Form Documents ... - Caresource

Get Health Partner Change Request Form Documents ... - Caresource

CareSource Provider/Group Hierarchy Change Request Form Date: PR Rep: Adding a Provider (Adding a provider to a participating group) Deleting a Provider (Deleting a provider from a participating group).

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CareSource Medicaid is available across the state of Ohio. When you apply for Ohio Medicaid, you can choose CareSource as your managed care plan.

You can call CareSource Member Services at 1-800-488-0134 (TTY: 1-800-750-0750 or 711). Member Services is open from 7 a.m. to 8 p.m., Monday through Friday. We are closed on certain holidays.

Medicaid health care coverage is available for eligible Ohioans with low income, pregnant women, infants and children, older adults and individuals with disabilities. CareSource Medicaid is available across the state of Ohio. When you apply for Ohio Medicaid, you can choose CareSource as your managed care plan.

Providers may file a written claim dispute no later than 12 months from the date of service or 60 calendar days after the payment, denial or partial denial of a timely claim submission, which is later. Submitted complaints should include: The member's name, CareSource member ID number and date of birth.

Clinical Appeals If you disagree with a clinical decision we have made regarding medical necessity, we make it easy for you to be heard. After receiving a letter from Humana – CareSource® denying coverage, the provider or the member can submit a clinical appeal within 60 calendar days of receipt.

(1) Claims are timely if received by ODM within: (a) Three hundred sixty-five days of the actual date the service was provided. (b) Three hundred sixty-five days from the date of discharge for inpatient hospital claims.

CareSource would like to remind you of the timely claims filing update for Healthy Indiana Plan (HIP) and Hoosier Healthwise (HHW) members. Claims for services must be submitted by network providers within 90 days of the date of service (DOS).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232