Complaints

We hope you are happy with CareSource. If you are unhappy with anything, you should contact us as soon as possible. We want to hear about your concern so we can improve our service to you.

Grievances

If you have a concern, call our service center at 1-800-390-7102. We will try to solve the problem right away. If we can’t, we will investigate the problem and work with other CareSource staff to resolve it. We will call you within 72 hours with a plan of action or proposed solution.

If we don’t resolve the problem to your satisfaction, or if we don’t resolve it within 72 hours, you can file a grievance. Just call 1-800-390-7102 (TTY: 1-800-649-3777 or 711) and tell us about your concern.

Appeals
If you are not happy about a decision CareSource made about your health care, you can ask us to reconsider.  This is called an appeal.

• You can file an appeal by calling 1-800-390-7102.
  
  
• OR you can file an appeal by writing:
  CareSource,
  P.O. Box 1307, Dayton, OH 45401-1307
  
  
• Appeals must be filed within 90 days of CareSource’s decision, and will be resolved in 30 days of receipt.
  
  
• Expedited appeals can be filed within 90 days of CareSource’s decision.
  
  
• Expedited appeals are only for situations that are urgent, and will be processed within 72 hours of receipt.
  
  
• You may request a Private Informal Managerial Conference to explain your appeal and concerns directly to CareSource staff.  Here you can present your views, let a lawyer or someone else speak for you, see all documents in the file, add new evidence, submit written comments, question the committee or ask for a neutral member of CareSource staff to help present your case for you.
  
  
• If you do not choose to participate in the Private Informal Managerial Conference, your appeal will be submitted directly to the Appeals Committee for review.
  
  
• You will be notified of their decision within 30 days of filing your appeal.