CareSource Marketplace Ohio
Welcome to CareSource Marketplace Ohio page. Here you can download policies and procedures specific to both ordering providers and imaging facilities. These include quick reference guides and FAQs. You can also view information designed to assist you in using the RadMD Website to obtain and check authorizations.
If you have any questions about the NIA Program, please contact your dedicated NIA Provider Relations Manager, Meghan Murphy.
Update on COVID-19
Effective 1/1/18, in addition to the management of MR, CT and PET, prior authorization will be required for the following cardiac procedures for ONLY CareSource OH Exchange, Medicare, Medicare Advantage, ABD Adults and MAGI members as well as CareSource KY, WV and IN Exchange.
- Myocardial Perfusion Imaging (MPI)
- MUGA Scans
- Echocardiography (Transthoracic and Transesophageal Echocardiography)
- Stress Echocardiography
Note: The above cardiac procedures will NOT require prior authorization for Ohio CFC and ABD Kids and Indiana and Georgia Medicaid members.
Documents
- Frequently Asked Questions
- Prior Authorization Checklist
- Provider Education Presentation
- Quick Reference Guide for Ordering Providers
- Quick Reference Guide for Rendering Providers
- Tip Sheet for Ordering Advanced Imaging Studies
- CareSource Marketplace Ohio Utilization Review Matrix-2021
RadMD User References
- Ordering Provider Access
- RadMD Quick Start Guide
- RadMD Benefits and Logon
- RadMD Upload Feature
- Submitting Clinical Information on RadMD
- RadMD View Exam with Tracking Number
- RadMD Shared Access Quick Start Guide
- RadMD Flyer
Recorded General Trainings
Recorded RadMD Demos
Clinical Guidelines
- Clinical Guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by NIA
Clinical Training Modules
We have a series of clinical training modules that will help you avoid delays and ensure that you have the right information before submitting your prior authorization request. Click here to access them.