CareSource billing and credentialing
Billing and credentialing for CareSource Medicaid, Marketplace and dual plans.
Working with CareSource
CareSource is a nonprofit managed care organization offering Medicaid, Marketplace and dual-eligible plans in several states, including Ohio, Georgia and Indiana.
Plan types we bill:
- Medicaid managed care
- Marketplace plans
- Dual-eligible plans
Credentialing and enrollment
For Medicaid products, you must first be enrolled with the state Medicaid agency, then credentialed with the plan.
Credentialing uses your CAQH ProView profile, which must be complete and re-attested every 120 days.
Prepare
Licenses, NPI, CAQH and group details checked and updated.
Apply
Application submitted for each provider and location.
Follow up
Status checked every 1 to 2 weeks until approval.
Confirm
Effective date and participation confirmed before billing.
Claims, eligibility and portals
CareSource has its own provider portal for eligibility, claims and prior authorization, with state-specific policies.
Denials we prevent with CareSource
- Provider enrolled with the state but not credentialed with the plan
- Member assigned to a different plan this month
- Missing plan prior authorization
- Behavioral health or vision carved out to another vendor
- State-specific coding or modifier rules not followed
Questions about CareSource
Do you credential with CareSource in every state it serves?
Yes, following each state plan’s process.
Trademarks belong to their owners. MedAi Billing Solutions is an independent billing company, not affiliated with any payer or government agency.
Get help with CareSource claims
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.