HomeTown Health Roderick M. Alexander Health Partner Contracting Manager July 5, 2017

CareSource Updates WELCOME TO GO-LIVE!

CareSource Updates Welcome to the CareSource Network! We’re excited to have you on board. As we prepare to partner and provide healthcare to those who need it most, you may have some unanswered questions about working with us. Resources about our plan may be found on the CareSource.com Plan Resources web page. In addition to a Quick Reference Guide, the Provider Manual, Quick Links to the Provider Portal and a Formulary Search tool, you will also find answers to your Frequently Asked Questions about working with CareSource.

CareSource FAQs Can providers submit authorizations and claims through CareSource.com? Yes. For a more streamlined experience for health partners, CareSource offers our participating health partners the ability to submit claims electronically through the CareSource Provider Portal. Inpatient Admits Pre –July 1, 2017 A Georgia Families member admitted to an inpatient facility prior to July 1, 2017 will remain the responsibility of the admitting CMO until discharge. The admitting CMO will be responsible for both the facility and professional cost and care for the member through discharge. However, CareSource will work with the admitting CMO and the facility for transition of care and discharge. Beginning July 1, 2017, CareSource will honor a member’s active prior authorization issued by their previous CMO for a period of forty-five (45) days as a part of the transition of care process. After the forty-five (45) day transition of care period, non-participating providers can submit an authorization request through the GAMMIS Centralized PA Portal for the following services:  Services in an Inpatient (POS21), Outpatient (POS22) or ASC (POS24) setting  Durable Medical Equipment  Children’s Intervention Therapy Services  Notification of Pregnancy  Newborn Delivery Notification  Outpatient Behavioral Health

CareSource Ombudsman The CMO Ombudsman staff facilitate provider and member inquiries for expedited resolutions. The Ombudsman Coordinator is defined as an employee of the CMO who is responsible for coordinating services with local community organizations and working with local advocacy organizations to assure that Members have access to Covered Services and non-Covered Services. The Ombudsman Liaison is defined as an employee of the CMO who is responsible for collaborating with DCH's designated staff in the identification and resolution of issues. Such collaboration includes working with DCH staff on issues of access to Health Care services, and identifying the communication and education needs of Members, Providers and caregivers. The Ombudsman Liaison must assist Members and Providers in coordinating services with local community organizations. Phone: 678-214-7580 Email: GAombudsman@caresource.com

Health Partners Team Health Partner representatives have been assigned to each region of the state. CareSource will have Health Partner Contracting Managers to provide training, education and support to providers. For general Provider inquiries, please email us at: GAProviderRelations@CareSource.com