How To
Please make sure that any patient who presents a CareSource member ID card is an eligible member of CareSource before rendering services. To learn all the convenient ways you can do this, please click on Check Member Eligibility.
CareSource requires members to get a referral from their PCP before accessing some services. To find out which services require a referral and how to give one, please click on Make a Referral.
CareSource require providers to obtain prior authorization before rendering some services. To find out which services require prior authorization and how to get it, please click on Request Prior Authorization.
CareSource makes it easy for providers to submit paper or electronic claims for services rendered. To find out how to fill out forms and where to send claims, please click on Submit a Claim.
To submit a clinical or non clinical dispute to CareSource, please see Dispute Resolution
Please note that when billing CareSource for dental services on supernumerary teeth, please bill the tooth number using the approriate code for that supernumerary tooth. 51-82 and AS-TS
We want all participating providers to be happy with CareSource. However, if you disagree with a medical necessity decision we have made or would like to dispute a claim, we make it easy for you to be heard. To find out how, please see File an Appeal.
You can also help us keep fraud out of managed health care. To find out more, please click on Report Fraud.
For more information about all these policies and procedures, please call the CareSource service center at 1-800-488-0134 or see the Provider Manual.