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 Web site to obtain and check authorizations.
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 (PDF 201K)
- Prior Authorization Checklist (PDF 83K)
- Provider Education Presentation (PDF 2,541K)
- Quick Reference Guide for Ordering Providers (PDF 241K)
- Quick Reference Guide for Rendering Providers (PDF 191K)
- Tip Sheet for Ordering Advanced Imaging Studies (PDF 845K)
- Utilization Review Matix (PDF 195K)
- RadMD for Ordering and Imaging Providers (PDF 91K)
- RadMD Quick Start Guide (PDF 450K)
- RadMD Upload Feature (PDF 435K)
Clinical Guidelines
- Clinical Guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by NIA