How To

CareSource makes it easy for participating providers to work with us. Our processes to check member eligibility, make a referral, obtain a prior authorization, and submit a claim are simple and straightforward. We even make it easy for providers to file a complaint and report fraud.

Because Michigan Medicaid rolls change each month, we ask providers to make sure that any patient who presents a Michigan Medicaid or CareSource ID card is an eligible member before rendering services. To learn how to do this, please click on Check Member Eligibility.

CareSource requires members to get a referral from their PCP before accessing some services. To find out how to refer a member, please click on Make a Referral.

CareSource requires providers to obtain prior authorization before rendering some services. To find out how to get it, please click on Get Prior Authorization.

CareSource makes it easy for providers to submit paper or electronic claims for services rendered. To find out how to fill out forms and where to send claims, please click on Submit a Claim.

We want all participating providers to be happy with CareSource. However, if you disagree with a medical necessity decision we have made or would like to dispute a claim, we make it easy for you to be heard. To find out how, please see File an Appeal.

CareSource has a comprehensive program designed to handle fraudulent or abusive activity by providers, members and employees. Please help us by reporting fraud.  To find out how, please see Report Fraud.

For more information, please call the service center at 1-800-390-7102 or see the Provider Manual.