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caresource ohio dental handbook

by Prof. Deon Reynolds MD Published 3 years ago Updated 3 years ago

What is the CareSource 2D dental manual?

2 DEAR CARESOURCE®DENTAL PROVIDER, CareSource values our relationship with you and is working to strengthen that partnership. At CareSource, our goal is to help you improve and maintain the dental health of our members. The Dental Manual is part of an initiative to improve effi ciency and consistency

How to contact CareSource health partner services for dental services?

• tooth/teeth having advanced periodontal disease CareSource.com | CareSource Health Partner Services:1-800-488-013420 CareSource | Health Partner Dental Manual D. Other Restorative Services D2930 Prefabricated stainless steel crown – primary tooth • Stainless steel crowns are allowed only for teeth when multi-surface restorations are

Does CareSource Medicare Advantage cover dental?

• CareSource Medicare Advantage, a managed care plan with an enhanced dental benefi t that is not covered by original Medicare. Coverage includes preventive dental services such as cleaning, routine dental exams and dental X-rays. CareSource distributes member rights and responsibility statements to the following

What kind of photos does CareSource accept for dental work?

- CareSource accepts high quality diagnostic photographs and X-rays. • Plaster models are no longer accepted for prior authorization. CareSource.com | CareSource Health Partner Services:1-800-488-013410 CareSource | Health Partner Dental Manual

Dental Provider Manual

The dental provider manual is a resource for our dental providers and serves as a link between your office and CareSource. It provides important information on topics such as covered services, services that require prior authorization, claim submission and more.

Updates & Announcements

We continually update information, both on a periodic and an as-necessary basis, and the content in the manuals is subject to change without notice. We post updates through network notifications on the Updates & Announcements page. Please check this webpage often to stay current with all updates.

Join Our Network

DentaQuest has a NEW and improved Online Enrollment and Credentialing Tool! Learn how to use this new tool (and more) by attending one of our scheduled WebEx trainings. Please click here to access the training schedule.

Enroll by Mail

We encourage you to complete your credentialing application online . However, we understand an online solution is not everyone’s preference. If you prefer to complete a paper application, please call your provider relations representative.

CAQH Sign Up

The Council for Affordable Quality Healthcare (CAQH) offers a single credentialing application and an online database that contains information necessary for insurance companies to credential a provider. This allows you to submit and maintain your credentialing information at one location rather than filing with many organizations.

Important Dentist Information

Office Reference Manuals can be found on the provider portal, please click on the following link to be redirected to the provider portal: https://govservices.dentaquest.com

Marketplace Providers: Telehealth HEDIS Measure Quick Reference Guide is Available!

The landscape of telehealth has quickly evolved over the past year. Recent policy changes have expanded the use of telehealth to deliver acute, chronic, primary and specialty care to preserve and support the patient-provider relationship.

Ohio Home Care Waiver Provider Portal Update Reminder

The Ohio Home Care Waiver Program case managed by CareSource has moved to a new system platform on April 1, 2021. The changes have enhanced the individual and provider experience. There will be new individual and provider portals that will look and act differently. Providers can get help by calling Provider Services at 1-800-488-0134.

NPI Needed for Ohio Medicaid and MyCare Waiver Providers

WAIVER Providers must have a National Provider Identifier (NPI) by Oct. 1, 2021 or claims will be denied. For more information, please click here.

Enhancements to Authorization on the Provider Portal

CareSource is excited to announce additional enhancements for the Provider Portal. In addition to initiating your prior authorization request through the provider portal, you can now submit requests to update your authorization requests. For example, you will now be able to add additional documentation or change dates of service.

ICD-10-CM diagnosis coding and Risk Adjustment education sessions and webinars

CareSource has partnered with Pulse8 and we are offering on line ICD-10-CM diagnosis coding and Risk Adjustment education sessions and webinars. The Webinar details:

Payment Review

Payment Review Tool – Use this tool to reference CareSource’s pre- and post-payment review processes and appropriate contacts.

MyCare Waiver Services Prior Authorization Reminder

CareSource would like to remind all MyCare Waiver providers that all waiver codes require a prior authorization. To learn more, view the network notification.

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