Find the right department

Provider appeals fax listed for Indiana Medicaid (the manual also lists 937-531-2398). Provider appeals mail: CareSource, Attn: Provider Appeals, P.O. Box 2008, Dayton, OH 45401-2008. Clinical appeals: Attn: Provider Clinical Appeals, P.O. Box 1947, Dayton, OH 45401-1947.

Medical-benefit (physician-administered) drug PA fax. Source: IHCP Quick Reference Guide v14.1 (state agency list of MCE contacts), not the plan's own page.

Demographic changes (address, phone, adding/deleting practitioners); portal Provider Maintenance is preferred. Also update with IHCP. Contract implementation fax: 937-396-3632.

Right Choices Program for HIP and Hoosier Healthwise members (phone 844-607-2829). Source: IHCP Quick Reference Guide v14.1 (state agency list of MCE contacts), not the plan's own page.

Superior Vision provider customer service; fax is for vision utilization management (PA). Source: IHCP Quick Reference Guide v14.1 (state agency list of MCE contacts), not the plan's own page.

Contract implementation (new contract loading) for Ohio Medicaid and MyCare Ohio. | Contract implementation fax listed in the Indiana Medicaid provider manual.

Refer Ohio Medicaid/MyCare members for care management.

Report suspected fraud, waste or abuse; may be anonymous.

Ohio Medicaid claim inquiries (same IVR as provider services). EDI through an ODM-authorized trading partner (OMES) uses CareSource ODM Payer ID 0003150. Paper CMS-1500/UB-04 claims go to the mailing address. Timely filing 365 days (OAC 5160-1-19).

Ohio Medicaid medical PA by phone, fax or Provider Portal. Outpatient pharmacy PA is handled by the ODM single PBM (Gainwell), not CareSource.

Member appeals and grievances (not provider claim disputes). Member line 1-800-488-0134.

Medical PA fax for CareSource MyCare Ohio (HMO D-SNP). Phone is the shared provider services/PA line.

Medicare Part D formulary exception/prior authorization form for CareSource MyCare Ohio (HMO D-SNP) only; not for Medicaid.

Member-facing line for CareSource MyCare Ohio (HMO D-SNP). Ohio Medicaid members use 1-800-488-0134.

MyCare Ohio pharmacy PA fax 877-251-5896; the Medicare Part D formulary exception/prior authorization form fax listed on the same flier is 877-328-9660.

Ohio Medicaid pharmacy PA for physician-administered drugs (outpatient, medical benefit) only. Retail/outpatient pharmacy PA goes to Gainwell SPBM.

Provider claim disputes/appeals for Ohio Medicaid and MyCare Ohio: Provider Portal, fax, verbally via provider services, or mail. Clinical disputes decided in 30 business days, non-clinical 15 business days.

Demographic/practice updates for Ohio. For Ohio Medicaid, ODM PNM is the system of record: update PNM first; CareSource will not accept changes inconsistent with PNM data.

Care management referrals.

Medical prior authorization (also used to load post-stabilization/retro-eligibility authorizations). GAMMIS centralized PA portal is also available.

Paper medical claims mailing address (portal submission preferred). ECHO EFT enrollment support: 1-833-629-9728.

Pharmacy claims submissions by mail; pharmacy questions to provider services.

Provider appeals fax and mailing address (provider manual contact tables).

Provider maintenance fax for practice/demographic changes.

Georgia Families (Medicaid/PeachCare for Kids) provider services. The contact page lists this same number for medical PA, pharmacy PA, pharmacy help desk, claims and appeals; the IVR routes calls.

Sick newborn fax listed with the Georgia Medicaid prior authorization contacts.

Independent, neutral CareSource department for member/provider concerns; toll-free 1-877-683-8993.

ECHO Health handles CareSource provider payment/EFT enrollment questions.

Paper claims (encouraged only when clinical documentation is required; portal upload also available). Provider Services 1-833-230-2112 for claim questions.

Hours are not assigned because the current national provider-contact component and Nevada Health Partner Engagement page give different opening times. Prior authorization has a separately documented fax and portal-support email.

TurningPoint manages prior authorizations for cardiac and musculoskeletal surgical procedures for CCA; website myturningpoint-healthcare.com. The guide shows different fax numbers in its before/after columns, so the fax is withheld.

CCA moved to the CareSource provider platform on June 28, 2026 (portal providerportal.CareSource.com/MA); this line uses the column of the CCA transition guide labeled "New Information Beginning June 28, 2026". Credentialing also through the new provider portal. Contract questions: CCAContracting@CommonwealthCare.org.

SKYGEN (Scion) administers CCA dental; portal pwp.sciondental.com.

CCA moved to the CareSource provider platform on June 28, 2026 (portal providerportal.CareSource.com/MA); this line uses the column of the CCA transition guide labeled "New Information Beginning June 28, 2026". Preferred: new provider portal (Providers > Prior Authorizations and Notifications). After June 28, 2026 the guide lists 855-341-0720 for both medical PA and inpatient/TOC faxes. Use the Procedure Code Lookup Tool on CCA Forms and Referrals to check requirements.

EviCore by Evernorth (Care Continuum) handles Part B / medical specialty drug administration authorizations for CCA; electronic requests at EviCore.com.

Member line for CCA One Care and Senior Care Options; not for provider claims. TTY: 711.

CCA moved to the CareSource provider platform on June 28, 2026 (portal providerportal.CareSource.com/MA); this line uses the column of the CCA transition guide labeled "New Information Beginning June 28, 2026". Preferred: Online Claim Submission in the new portal or EDI. CCA payer ID A2793. Before June 28, 2026 the guide listed CCA Claims, P.O. Box 3085, Scranton, PA 18505.

CVS Caremark handles Part D coverage determinations and redeterminations (submit within 65 days of denial). The guide lists two different phone numbers across its columns (1-855-344-0930 and 1-833-251-9739), so only the fax and mailing address are given here.

CCA moved to the CareSource provider platform on June 28, 2026 (portal providerportal.CareSource.com/MA); this line uses the column of the CCA transition guide labeled "New Information Beginning June 28, 2026". Portal (Claims > Appeals) is preferred; phone, fax and mail are alternatives. The guide also lists the same P.O. Box for Part B pharmacy appeals.

Provider relations (training, orientation). Demographic updates: PNMDepartment@CommonwealthCare.org or the Provider Maintenance page of the new portal.

CCA moved to the CareSource provider platform on June 28, 2026 (portal providerportal.CareSource.com/MA); this line uses the column of the CCA transition guide labeled "New Information Beginning June 28, 2026". Claims status, receipts, payments, corrected claims, refunds and escalations for CCA Senior Care Options, One Care and Medicare Advantage.

EyeMed administers vision for CCA Senior Care Options and One Care.

HAP CareSource Michigan Medicaid: one number for medical and pharmacy prior authorization, pharmacy help desk, claims and appeals. EDI payer ID MIMCDCS1 (hap.org).

Phone for PA: 1-833-230-2102. All inpatient services require PA.

MI Coordinated Health (HIDE-SNP dual plan) benefits, claims, eligibility, remittance and prior authorization. EDI payer ID MIMCRCS1.

ECHO EFT customer support 1-888-834-3511 per the same page.