doxo helps over 7 million . Box 824Dayton, OH 45401-0824, CareSourceAttn: Provider AppealsP.O. In addition to initiating your prior authorization request through the provider portal, you can now submit requests to update your authorization requests. To see all available Qualified Health Plan options, go to the Health Insurance Marketplace website at HealthCare.gov . We look forward to helping you get the most from your CareSource coverage and have highlighted some great resources. We administer one of the nation's largest Medicaid-managed care plans and offer access to care through health insurance, including Medicaid, Health Insurance Marketplace, Medicare Advantage and dual-eligible programs. ET. doctor, request an ID Card and more. For questions not addressed on our website, please call Provider Services at1-855-852-5558. Kentucky Marketplace CareSource Marketplace Map 1 CareSource Marketplace Service Area 2021 July 29, 2020 Service Areas CareSource Service Area 2021 Not already Contracted to Sell for CareSource? Press Enter again after expanding an item to navigate to that page. The metal level categories are based on how you and CareSource share the cost of your health care. You can use theAvaility Portal Registration Guide to get signed up. Top 10 CareSource Provider Specialties in Kentucky: Family Doctor (35 providers) Internist (27 providers) Radiologist (19 providers) Emergency Doctor (14 providers) Pediatrician (Kids / Children Specialist) (12 providers) Anesthesiologist (9 providers) Dermatologist (Skin Specialist) (9 providers) Ophthalmologist (Eye Doctor) (9 providers) The Departments of the Treasury, Labor, and Health and Human Services (the Departments) Transparency in Coverage final rules (85 FR 72158) require non-grandfathered group health plans and health insurance issuers in the individual and group markets (plans and issuers) to disclose in-network negotiated rates and out-of-network allowed amounts in machine readable files. Bind. Join us and watch your business grow. Overpayment Recovery Form Submit this form to offset overpaid claims against a future payment. Enroll in the CareSource Marketplace Gold plan today. First Name Last Name Enter your last name exactly as it appears on your member ID card. Press Enter again after expanding an item to navigate to that page. CareSource also partners with Availity to offer electronic claim submission and real-time transactions at no charge through theAvaility Portal. Not already Contracted to Sell for CareSource? You can locate doctors/providers, pharmacies and covered medications. Call ECHO Customer Support at 1-888-834-3511. Use this list as a guide to help you find the appropriate contact for your questions. Fitbit or Garmin), digital workouts and live lifestyle coaching. Press Enter or Space to expand a menu item, and Tab to navigate through the items. Providers have the option to submit claims through oursecure, online Provider Portal. CareSourceAttn: ClaimsP.O. Outpatient practices may register as Practitioner to create a portal account for the practice Tax ID. This is a free service to our members. The CareSource ID card displays member copays for office visits on the front of the card in the purple box. We encourage you to submit claims online to take advantage of the following benefits: Refer to theprovider manualfor detailed information to submit claims. Interested in no-cost gym memberships? Login to the portal and select "Provider Maintenance" from the navigation. CareSource Contacts Provider Services: Ohio: 1-800-488-0134 Kentucky: 1-855-852-5558 Indiana: 1-866-286-9949 West Virginia: 1-855-202-1091 Provider Portal: https://providerportal.caresource.com Website: Find Marketplace resources at CareSource.com Utilization Management: Call Provider Services and select the menu option for prior authorizations . If this person would like specific information, they will need to email or call CareSource regarding their concerns. Find clinical tools and information about working with CareSource. You may need to download Adobe Acrobat Reader to open these files. Get quick access to prescription coverage, find a doctor or provider, use health and educational tools, and discover what you can do with your My CareSource account. Press Escape to collapse the expanded menu item. Copyright CareSource 2022. Evercare - Medicare. Data is accurate as of November 16, 2017 and subject to change. You will find: My CareSourceis a personal, online account that can help you get the most out of your member experience. Silver plans offer the highest value for those eligible for financial assistance. Health Partner Engagement Representativeswill be happy to answer your questions Monday through Friday, 8 a.m. to 6 p.m. You can also do business with us online any time of the day or night. Inc DBA HealthSherpa Insurance Agency and is not the Health Insurance Marketplace website. doctor, request an ID Card and more. check your deductible, change your Health Care Coverage Your Way. In addition to information about how to submit claims and check payments, CareSourceoffers you tools to find specific information, such as claim status and member coordination of benefits (COB) status. All rights reserved. If the Tax ID for your facility or practice has already created an account to utilize the CareSource Provider Portal, a new account cannot be created. CareSource is the fastest and easiest way to enroll in ACA / Marketplace health insurance. With more than 100,000 network providers across the coverage areas, and depending on your plan, you have plenty of choice when it comes to finding the best care available to meet your health needs. Our Navigate CareSource is a Qualified Health Plan offered through the Health Insurance Marketplace. Copyright CareSource 2022. Box 2008Dayton, OH 45401-2008. Bright Health. The complete premium dataset can be found on this technical database. All plans include pediatric dental and vision coverage. CareSource strives to make it easy for you to work with us, whether online or over the phone. Our files are locatedhere. These are the only plans that offer cost-sharing reductions (CSRs) in addition to premium tax credits. Through our Zero Cost Telehealth Partner Program, you have access to $0 copay telehealth office visits. Need to take a trip to the eye doctor or dentist? Get Contracted by following the link below. Over 70% of people who enroll in a CareSource Health Insurance Marketplace plan also qualify for a government-funded subsidy that substantially lowers the overall cost of the plan. Including 24 hour nurseline, wellness advocates, incentive programs, specialty care teams, and other innovative support like our MyHealth and myStrength tools. AL AR AZ CA CO CT DE FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC NE NH NJ NM NV NY OH OK OR PA RI SC TN TX UT VA WA WI WV WY. So, if you need health insurance this open enrollment period, CareSource can help. At the end of the grace period, if the member is terminated due to non-payment of premium, CareSource will recoup any payments made for claims received in the second and third months of the grace period. Qualifying life events include, but are not limited to: To find out if you are eligible for a Special Enrollment Period, give us a call at 1-844-539-1733 (TTY: 711.). Coventry National. Use the online Tell Us form to send us your question or request. CareSource . This is a free service. ChampVA. Join us and watch your business grow. You pay more each month for a Gold plan than you would for another metal level. CIGNA. Use the portal to pay your premium, You may want or need to end your Marketplace insurance plan if you get other health coverage, or for other reasons. CareSource Provider Overview Provider Portal Provider Portal Prior Authorization View prior authorization requirements and submit authorization requests. CareSource plans have some of the lowest in-network primary care or retail clinic copays. Health insurance should help you stay healthy. bill pay. Contact the SHOP Call Center 1-800-706-7893 (TTY 711) Mon- Fri 9 a.m. - 5 p.m. Other telehealth office visits have the same cost share as your Primary Care Physician and non-office visits have the same cost share as an in person visit. Enter the member information to make a payment. Member Services: 1-888-815-6446 (TTY: 1-800-648-6056) 7 a.m. to 7 p.m., Monday through Friday. We offer different Silver plan options so you can choose the one that fits your budget and healthcare needs. MARKETPLACE SEE HOW CARESOURCE CAN SAVE YOU MONEY ON HEALTH INSURANCE 1-844-539-1733 (TTY: 711) Shop or Enroll WE GOT YOU. Press Enter or Space to expand a menu item, and Tab to navigate through the items. Press Enter again after expanding an item to navigate to that page. When you enroll, youll see if you qualify. Log in orcreate your My CareSource account. Our prescription drug coverage includes copays as low as $0 for generic drugs and an extensive list of brand name drugs. Press Escape to collapse the expanded menu item. Results are provided "AS IS" and "AS AVAILABLE" and do not . The Fitness Benefit provides access to multiple fitness centers and gyms, digital fitness choices with home fitness tools, including one home fitness kit per benefit year with some kits including a wearable device (e.g. Enrollment in CareSource Medicare Advantage plans depends . Blue Cross Blue Shield/Anthem of Kentucky. Users - User Registration. Within every county in the Commonwealth, KHBE provides access through insurance agents or kynectors who can help complete applications and find affordable . Blue Grass of Kentucky. Step 1 of 3 - Provider Eligibility. HealthSherpa is the fastest and easiest way to enroll in 2023 Marketplace health insurance. Find clinical tools and information about working with CareSource. Eligibility for these funds is determined by the Health Insurance Marketplace, and not by CareSource. All rights reserved. All CareSource Marketplace plans include TruHearing coverage with hearing aid discounts and $0 copay for routine hearing screenings. Established in 1989 Please see our Fraud, Waste &Abuse page for more information or call the Fraud Hotline: 1-844-415-1272 (Follow the prompts for reporting Fraud). For questions not addressed on our website, please call Provider Services at 1-855-852-5558 Our Health Partner Engagement Representatives will be happy to answer your questions Monday through Friday, 8 a.m. to 6 p.m. Health insurance & health reform authority October 7, 2022 Key takeaways Read frequently asked questions about marketplace enrollment, rates and carriers in Kentucky Kentucky is creating a Basic Health Program that will debut in the fall of 2023, for coverage effective in 2024 (only two other states have BHPs) We want to make it as easy as possible to conduct business with us. Enroll with ECHO for payment and choose EFT as your payment preference for CareSource. Copyright CareSource 2022. (844) 967-1917 | Find an agent | Text Size | Home; Plans; Insurance; FAQs; How You Save; Shop Online; Search. Some of these plans are health savings account (HSA) compatible and include the following benefits: Essential benefit coverage CareSource has partnered with ECHO Health, Inc. to deliver provider payments. CareSource accepts claims in a variety of formats, including online and paper claims. Need to request a new ID card or access claim information? . Need to find a new doctor or see if your prescription medicine is covered by CareSource? You pay less each month for a Bronze Plan, but these plans have the highest deductibles and other out-of-pocket costs. Press Enter or Space to expand a menu item, and Tab to navigate through the items. 2023 Wellcare Marketplace Map. Get Contracted by following the link below. Join us and watch your business grow. Our Member Services staff will be happy to answer your questions. The Kentucky Health Benefit Exchange provides support and resources for Kentuckians to enroll in health coverage and learn what health insurance and other programs they may be eligible for. CareSource offers Marketplace plans in Indiana, Ohio, Kentucky, and West Virginia. CareSource fully supports your choice to use telehealth and is willing to partner with your Provider. With a Gold plan, the amount you pay each time you get a health service, such as seeing a doctor or filling a prescription, is less than what youd pay if you have a Bronze or Silver plan. If you have questions about your health, CareSource24 provides around-the-clock access to a caring and experienced staff of registered nurses. Definity Health. You will receive a response within one business day. User Registration. Join us and watch your business grow. Attention: This website is operated by CareSource and is not the Health Insurance Marketplace website at HealthCare.gov. Get Contracted by following the link below. You can also download the free CareSource mobile app to use many of these features on-the-go. Health Care Coverage Your Way. Adults get enhanced benefits by adding optional Adult Dental, Vision & Fitness Benefits*** to any Silver, Bronze or Gold plan. A team of nurses who can answer health questions 24/7/365. GEHA PPO USA . 2023 Molina Marketplace Map. Note that many CareSource members are also eligible for helpful government subsidies, which will lower your cost for health care. You can find information fast and submit requests online anytime day or night by clicking on Tools and Resources. Get Contracted by following the link below. You can submit claims, track claim payments and more. KHBE.Questions@ky.gov KHBE Contact Center: 1 (855) 459-6328 KHBE Office: (502) 564-7940 Address: 275 East Main Street 4-WE This website does not display all Qualified Health Plans available through HealthCare.gov. If you get a message that the provider does not exist in Provider Portal, you can call the help line at 1-800-488-0134 (Medicaid, Marketplace and MyCare) or 1-844-679-7865 (Medicare Advantage). Reimbursement is based on the prevailing state Medicaid or Medicare fee schedule. Application ID: * NPI: * We offer individual and family plans with optional dental and vision coverage for adults. ECHO offers three payment options: *Payment processing fees are what you pay your bank and credit card processor for use of payment via credit card. CareSource strives to make it easy for you to work with us, whether online or over the phone. The plans, all of which offer health coverage, include: Get Started Skip. Our plans are simple and affordable with coverage for pre-existing conditions and no annual or lifetime dollar limits for essential health benefits. There will be new individual and provider portals that will look and act differently. CareSource is an HMO with a Medicare contract. Home (844) 967-1917. Submit Claims Online Providers have the option to submit claims through our secure, online Provider Portal. doctor, request an ID Card and more. CareSourceaccepts claims in a variety of formats, including online and paper claims. Health Partner Engagement Representatives. Financial Assistance. CareSource does not represent or warrant, whether expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose the results of the Procedure Code Prior Authorization Lookup Tool ("Results"). This website contains information that will help you understand your CareSource insurance coverage. Simple, protected. We strive to make it easy for doctors, members and the community to work with us, whether online or over the phone. Press Enter again after expanding an item to navigate to that page. This can be used no matter which plan you enroll in. Click on the link to shop and compare plans, grab a FREE quote, and sign up for coverage. Copyright CareSource 2022. This website does not display all Qualified Health Plans available through HealthCare.gov. Copyright CareSource 2022. Providers can get help by calling Provider Services at 1-800-488-0134. Find clinical tools and information about working with CareSource. (502) 326-1800 4642 Chamberlain Ln Ste 252 Louisville, KY 40241 OPEN NOW Such a positive experience. About the Affordable Care Act Regulatory and Policy Information For Navigators, Assisters & Partners For Agents & Brokers Optional Adult Dental, Vision & Fitness benefit plans are also available. Fortified Provider Network. Not already Contracted to Sell for CareSource? Press Enter or Space to expand a menu item, and Tab to navigate through the items. If you dont expect to have many doctor appointments or need many prescription drugs, this may be a good choice for you. Lower out-of-pocket costs. Due to HIPAA guidelines, CareSource is only able to provide general information regarding anyone over the age of 18 years old, without their permission or required documentation. . To see all available Qualified Health Plan options, go to the Health Insurance Marketplace website at HealthCare.gov . My CareSource Rewards Program Through the My CareSource Rewards Program , you can earn up to $365!. Bronze plans have: Lowest premiums. All plans include pediatric dental and vision. If you choose Marketplace coverage, you can benefit from a subsidy on the monthly premium if your income qualifies. And, back in 2017, Georgia added CareSource to its Medicaid roster.CareSource, a nonprofit corporation headquartered in Dayton, Ohio, now operates in five states. The Ohio Home Care Waiver Program case managed by CareSource has moved to a new system platform on April 1, 2021. Check Enrollment Status. Weve been helping our members through uncertain times for over 30 years. 2023 Caresource Marketplace Map. All plans include pediatric dental and vision. Marketplace Plans. If you have additional general questions about the New Health Partner Contract Form, call Provider Services at 1-855-852-5558. Refer to the provider manual for instructions to submit paper claims. CareSource offers this service at no cost. Use the portal to pay your premium, Press Escape to collapse the expanded menu item. Not already Contracted to Sell for CareSource? Find clinical tools and information about working with CareSource. CareSource Marketplace Gold Dental, Vision + Fitness Plan Overview Office Visit Prescription Drug Information Inpatient Coverage Emergency and Urgent Care Links Summary Of Benefits Plan Overview Office Visit Prescription Drug Information Inpatient Coverage Emergency and Urgent Care Emergency Room Standard: $400 Copay after deductible CHICAGO, Oct. 27, 2022 /PRNewswire/ -- Easterseals announced today that it has received a donation of $2.55 million from CareSource, a nationally recognized leader in managed care with a legacy. SEE HOW CARESOURCE CAN SAVE YOU MONEY ON HEALTH INSURANCE. You can also contact your Care Manager with questions. We can read the information aloud for you, in English, or in your primary language. Enter your Application ID and NPI to check the status of your enrollment.. All rights reserved. 2023 Anthem Marketplace Map. CareSource rewards its members for taking a proactive role in their health and well-being. Member-Related Forms PCP Change Request Form If you send us your question or request on a Friday, you will get a response by Monday of the next week. What is your email? You have made the right choice. You have made the right choice. Attention: This website is operated by CareSource and is not the Health Insurance Marketplace website at HealthCare.gov. We also can help you if you are visually or hearing impaired. OPTIONAL ADULT DENTAL, VISION AND FITNESS BENEFITS, Moving outside your insurers coverage area, Having a change in income or household status that affects eligibility for advance premium tax credits or cost-sharing reductions if you are already enrolled in coverage through the Marketplace, Adopting a child or placing a child for adoption or foster care, Losing other qualifying health coverage due to losing job-based coverage, divorce, COBRA expiration, aging off a parents plan, losing eligibility for Medicaid or CHIP (Childrens Health Insurance Plan) and similar circumstances. check your deductible, change your Five health plans offered in 2021 for Kentuckians on the federal marketplace (www.healthcare.gov), offered by CareSource Kentucky Company, are currently unavailable for plan comparison, according to the Center for Medicare and Medicaid Services, which maintains the federal marketplace. Create a password: Use at least 8 characters. Anthem Blue Cross and Blue Shield Kentucky Medicaid. Bronze plans offer the most affordable premiums. CareSource is a Qualified Health Plan offered through the Health Insurance Marketplace. CareSource is a nonprofit, multi-state health plan recognized as a national leader in managed care. Press Enter or Space to expand a menu item, and Tab to navigate through the items. Use the portal to pay your premium, CareSource accepts claims in various formats, including paper and electronic claims. check your deductible, change your In 2022, CareSource Member Services will be closed in observance of these holidays: Is there a CareSource member in your family who: We can get someone who can sign or speak your language to help you talk with us or your doctor over the phone or in person. When and how you end your Marketplace plan depends on two things: The reason you're ending coverage (like if you get a job-based plan, if you qualify for Medicaid or Medicare, or if you simply want to end coverage) First Name: Last Name: Member Number: Date of Birth: AM-EXCM-0753. cover sheet and itemized statement for high dollar claims. If you have any problems reading or understanding this information, please call our Member Services team or use our TTY for hearing impaired members at the number below. CareSource marketplace plans provide comprehensive, quality coverage that you can afford, understand and use. CareSource knows health care can be confusing. All rights reserved. If you have had a qualifying Life Event within the last 60 days, the Health Insurance Marketplace will grant you a Special Enrollment period. Press Escape to collapse the expanded menu item. CareSource. Not already Contracted to Sell for CareSource? .Babies should see a health care provider for a well-child visit at least six times between birth and 15 months, says the American Academy of Pediatrics..provider for a well-child visit at 2023 Dental Marketplace Service Areas. Four out of five customers can get a Marketplace plan for under $10 a month with financial help!**. Thats why there are no copays or coinsurance fees for defined preventive health services with CareSource Marketplace plans. My Caresource Create an Account * indicates a required field What is your name? Our plans are simple and affordable with coverage for pre-existing conditions and no annual or lifetime dollar limits for essential health benefits. Join us and watch your business grow. We monitor and take action on any member or provider fraud, waste and abuse. Just Kids Pediatric Dentistry Dentists Pediatric Dentistry Clinics BBB Rating: A+ You cansubmit claims, track claim payments and more. CareSource Find a Doctor. Choice Care / Humana PPO. View or Submit Provider Disputes & Appeals View grievance requirements and time frames and submit grievances. Get 2023 health insurance plan info on CareSource Marketplace Bronze (None) from CareSource Kentucky of KY - premiums, out-of-pocket maximums, prescriptions, and more. FISERV. With Marketplace Plans, you can make claims inquiries at (866) 286-9949 (Indiana), (855) 852-5558 (Kentucky), (937) 224-3300 (Ohio), (678) 214 7500, (Georgia) and (855 . Front of the next week of benefits and more to submit claims online have For defined preventive Health Services with CareSource Marketplace plans a team of nurses who can answer Health questions 24/7/365 Marketplace! Subsidy on the front of the lowest in-network primary care or retail clinic copays and portals. Help complete applications and find affordable and vision coverage for pre-existing conditions and no annual or lifetime limits. 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