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- caresource hierarchy form
CareSource Provider/Group Hierarchy Change Request Form Date: PR Rep: Group IRS Name (Must Match Line 1 (one) on W9)Adding a Provider (Adding provider to a participating group) Deleting a Provider.
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QFPP FAQ
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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.
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Please call Member Services at the number below if you have any questions. Member Services: 1-800-488-0134 (TTY: 1-800-750-0750 or 711), Monday – Friday 7 a.m. – 8 p.m.
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The Ohio Medicaid Payer ID (receiver Id) is MMISODJFS.
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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.
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CareSource Attn: Claims Department P.O. Box 8730 Dayton, OH 45401-8730 Timely Filing: 365 calendar days from the date of service or discharge CareSource encourages providers to submit claims electronically for the most efficient processing.
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EDI Clearinghouses Please provide the clearinghouse with the CareSource payer ID number: 38325.
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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.
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CareSource® MyCare Ohio is a Medicare-Medicaid plan that delivers extra benefits and the coordinated care needed by both patients and caregivers, giving patients more coverage and caregivers more options. QUESTIONS? GIVE US A CALL. 1-855-475-3163. (TTY: 711)
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Related links form
- DoL WH-380-E 2020
- TX VS-170 2019
- WA RPD-224-003 2020
- WA DR-500-009 2020
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