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Claims Payment Appeals
Providers may appeal claims payment denials within 90 days of receiving notification of the denial. Claims payment appeals should include:
- Member’s name and identifying information
- Claim number
- The service for which payment was denied
- Date(s) of service
- The reason CareSource’s decision to deny payment should be reconsidered
- Any clinical notes or other medical information to support your request
When submitting an appeal for a claim dispute it’s important to send the clinical notes. In order to conduct a thorough review, CareSource needs all the pertinent clinical information to make the appropriate determination of the claim.
We will notify you of a decision within 30 days, and any needed adjustments will be made to a future payment.
Claims appeals should be addressed to:
CareSource-Provider Appeals
P.O. Box 2008
Dayton, OH 45401-2008
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