What's New for Providers

Highlights of the Latest Provider Newsletter

Here are a few of the top stories from the Summer 2010 ProviderSource newsletter, which mailed in late April.

• Facility Claims Editing Now in Effect
• Diagnostic Imaging Management Program Begins in October
• Community Health Excellence Program Off to a Great Start
• Clear One E-Updates
• Healthcare Reform Information
• Weight Watchers Program
• Upgrades to InTouch and Online Provider Directory
• 2011 Code Books Available at Discount Prices

Read the entire issue now. If you did not receive your copy in the mail, please contact your Provider Service Representative. You can also read past issues on our Newsletters page.

Provider Manual Updated

We recently updated The PacificSource Physician and Provider Manual. Revisions have been made to the following chapters: 4, 8, 9, 10, and 11. If you keep a printed copy in your office, we ask that you recycle it and begin using this new edition now.

Please visit our  Physician and Provider Manual page for more information and to download the revised chapters.

PacificSource to Serve Oregon’s Children through New State Program

PacificSource has been selected as the statewide carrier for Oregon’s Healthy KidsConnect program. Healthy Kids is free or low-cost healthcare coverage for Oregon children that don’t have health insurance. We’re very pleased to have this opportunity to help make healthcare more accessible to families. In addition, the program will lead to greater collaboration with our network providers who provide important services to pediatric and adolescent populations. Here are a few facts about the program:

• Healthy KidsConnect began February 1, 2010.
• Authorized by the 2009 Oregon Legislature (House Bill 2116), the program is part of the State of Oregon’s Healthy Kids initiative for children that are without insurance. Over time, the state expects to enroll more than 30,000 children in Healthy KidsConnect.
• Providers will be reimbursed according to their PPO contract rates.
• Coverage provides comprehensive medical, pharmacy, vision, and dental benefits.
• Premium subsidies are available for low-income families seeking assistance.
• The program operates in conjunction with the Oregon Health Plan.
• The Office of Private Health Partnerships (OPHP) is the group policyholder for Healthy KidsConnect insurance. They set eligibility requirements, premium, out-of-pocket costs, and benefits, as well as collect the premium from participants.
• In addition to PacificSource, several carriers were selected to be regional carriers, allowing families to choose from more than one health insurer, depending on their location.

For more information on Healthy Kids, visit www.oregonhealthykids.gov.

Quality scores for Oregon doctors’ offices now available

A nonprofit health group released a new online health resource for Oregon patients. Quality scores for Oregon doctors’ offices and medical groups with four or more adult primary care physicians have been published on www.PartnerForQualityCare.org. Performance information on individual physicians will not be published. The Web site also provides patients with helpful tips for getting quality healthcare in easily understood language so they can be better partners in their own healthcare. PacificSource is pleased to be an active participant in this collaborative effort that includes doctors, hospitals, other health insurers, purchasers, government agencies, and consumers.

Alcohol and Substance Abuse Screening Reimbursed

We now reimburse providers for alcohol and substance abuse screening and brief intervention. Through identification and intervention, physicians may help our members avoid the potential negative health consequences associated with alcohol and substance abuse.

PacificSource will cover the use of the AUDIT screening tool (10 item version)—the Alcohol Use Disorders Identification Test. Please use CPT code 99408–alcohol and/or substance (other than tobacco) abuse structured screening and brief intervention services, 15 to 30 minutes.

For the AUDIT forms, guidelines, and additional references, please see the "Alcohol abuse screenings and references" section of our Practice Guidelines page.

Welcome to our New Members from Primary Health!

We recently completed the acquisition of Primary Health Plans of Idaho including the Riverside Benefit Administrators TPA and a majority interest in Idaho Physicians Network. Learn more about the transaction in our news release. Our new FAQ has answers to many questions you may have, and you can continue to contact the former Primary Health (now PacificSource Health Plans of Idaho) and IPN staff in Boise for assistance.