News and updates
Correction to Prior Notice: New Radiology Program Effective April 1, 2022
Our prior notice incorrectly listed the portal opening date as March 13, 2022. The correct portal open date is March 21, 2022 for dates of service April 1, 2022 and after. We apologize...
Access to Standards Content
Access to Care Survey is now conducted by phone
As a provider, you understand how access to care is vital to healthy communities. As required by Centers for Medicare and Medicaid Services (CMS...
March 2022 drug list change notification (Medicaid)
Quantity limit updates
The following changes to the covered drug list are effective March 15, 2022:
Type of Change: Utilization management added
Epinephrine solution auto-...
Prior Authorization Submission reminder
We are unable to accept prior authorization requests via email. Please submit all prior authorizations via our secure provider portal, InTouch. If you have any questions or concerns,...
April Drug List Change Notification
Updates on Existing Criteria
April 2022. The following changes to criteria are effective April 22, 2022:
Prior Authorization Criteria – Clinical Updates
Botox...
Correction: 2022 Medicaid Neuropsychological Code Updates - Effective 1/1/2022
Effective January 1, 2022, prior authorization requirements will remain on Neuropsychological codes. A prior authorization requirement will be added to code 96137 Psych or...
Mental Health/Substance Use Disorder – prior authorization change
PacificSource has removed the prior authorization requirement for mental health and substance use disorder residential and partial hospitalization treatment. This change is for our commercial members...
New Radiology Program Effective April 1, 2022
Effective April 1, 2022, PacificSource will transition the review of all outpatient diagnostic imaging services for PacificSource Community Solutions members to AIM Specialty Health.
Your...
An end to surprise medical bills
New legislation shields consumers from unexpected charges
Starting January 1, 2022, the federal No...
March Drug List Change Notification
Updates on Existing Criteria
March 2022. The following changes to criteria are effective March 22, 2022:
Prior Authorization Criteria – Clinical Updates...