News and updates
January 2021 Initial Claim Rejections
Effective January 1, 2021, PacificSource will be implementing additional industry standard rejections that will occur at our front door once they pass through the...
January 2021 Drug List Change Notification
Updates on Existing Criteria:
January 2021. The following changes to criteria are effective January 22, 2021:
Preauthorization Criteria – Clinical Updates...
December 2020 Drug List Change Notification
Updates on Existing Criteria:
December 2020. The following changes to criteria are effective December 22, 2020:
Preauthorization Criteria – Clinical Updates...
Telehealth Reimbursement and Behavioral Health Update
Reiterating our policy for telehealth services reimbursement and addressing requests for Behavioral Health telehealth, post-pandemic.
Annual changes to prior authorization requirements
Every year prior authorization requirements are subject to change; some codes are added while others are removed. Please see our prior authorization grid to confirm whether a service requires a prior...
November 2020 Drug List Change Notification
Updates on Existing Criteria:
November 2020. The following changes to criteria are effective November 22, 2020:
Preauthorization Criteria – Clinical Updates...
COVID-19 Provider Relief Plan FAQ
See our FAQ, COVID-19 Provider Relief Plan and Other Frequently Asked Questions (pdf), for answers to questions we’ve received from our provider community in response to the COVID-19 Provider Relief...
October 2020 Drug List Change Notification
Updates on Existing Criteria:
October 2020. The following changes to criteria are effective October 22, 2020:
Preauthorization Criteria – Clinical Updates...
Preauthorization Criteria – Clinical Updates...
How Teledentistry can add value to your practice
Teledentistry: what it is, and how it can help.
COVID-19 Benefit and Reimbursement FAQ
In our effort to support providers, we've compiled COVID-19-related answers to the most commonly asked questions about coding instructions, reimbursement provisions, telehealth, and more. We want to...