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OH CareSource Medicaid Provider Prior Authorization Request Form 2021
Get OH CareSource Medicaid Provider Prior Authorization Request Form 2021-2024
Phone: 18004880134 Fax: 18887520012Ohio Medicaid Provider Prior Authorization Request Form * indicates required fieldRoutine Patient InformationUrgent Date of RequestMember ID #*Members Last Name First.
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ELIGIBILITY FAQ
Who is responsible for obtaining prior authorization? The healthcare provider is usually responsible for initiating prior authorization by submitting a request form to a patient's insurance provider.
Who is responsible for obtaining prior authorization? The healthcare provider is usually responsible for initiating prior authorization by submitting a request form to a patient's insurance provider.
Providers can obtain prior authorization for emergency admissions via the provider portal, fax or by calling Provider Services at 1-800-488-0134. Written prior authorization requests should be submitted on the Medical Prior Authorization Request Form.
If you're a provider, call our Provider Hotline at 800-686-1516. If you're an Ohio Medicaid member, call our Consumer Hotline at 800-324-8680.
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.
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.
If you're a provider, call our Provider Hotline at 800-686-1516. If you're an Ohio Medicaid member, call our Consumer Hotline at 800-324-8680.
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.
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